The impact of driving time on pediatric TBI follow-up visit attendance
Jennifer P Lundine1,2, Jin Peng3, David Chen3
1Department of Speech & Hearing Science, The Ohio State University, Columbus, Ohio, USA.
Insights
Driving time impacts pediatric traumatic brain injury (TBI) follow-up. Families living 30-60 minutes away had better attendance, but socioeconomic factors also play a role.
Area of Science:
- Pediatric Neurology
- Public Health
- Rehabilitation Medicine
Background:
- Pediatric traumatic brain injury (TBI) requires consistent follow-up care.
- Understanding barriers to follow-up is crucial for improving patient outcomes.
- Geographic distance and socioeconomic status (SES) may influence healthcare access.
Purpose of the Study:
- To investigate the relationship between driving time and follow-up visit attendance in children with TBI.
- To determine if longer travel distances are associated with lower attendance rates.
- To explore the influence of injury severity and sociodemographic factors on attendance.
Main Methods:
- Retrospective chart review of 368 children hospitalized with TBI.
- Calculation of driving time from patient residence to the hospital.
- Logistic regression analysis to assess the impact of driving time on initial post-discharge appointment attendance, controlling for covariates.
Main Results:
- Most children attended their first follow-up appointment.
- Attendance was highest for patients living 30-60 minutes away and lowest for those living <15 minutes away.
- While longer driving times (30-60 min) initially showed higher odds of attendance compared to shorter times (<15 min), this association diminished after accounting for socioeconomic factors.
Conclusions:
- Driving distance is a significant factor affecting follow-up attendance for pediatric TBI patients.
- Neighborhood socioeconomic status (SES) may mediate or interact with the effect of distance on attendance.
- Addressing both geographic and socioeconomic barriers is essential for optimizing TBI care follow-up.
Abstract:
Objective: Examine the effect of driving time on follow-up visit attendance for children hospitalized with a traumatic brain injury (TBI). We hypothesized that families who lived further from the hospital would show poorer follow-up attendance.Participants: 368 children admitted to the hospital with TBI.Design & Outcome Measures: Using a retrospective chart review, we calculated driving time from patients' homes. The primary outcome was attendance at the first appointment post-discharge. We used logistic regression to examine the effect of driving time on attendance, including an analysis of the effects of injury and sociodemographic covariates on the model.Results: Majority of children attended their first appointment. Patients living 30-60 min from the hospital were most likely to attend, and those living 15 min away were least likely to attend. After adjusting for patient characteristics, families with driving time of 30-60 min had significantly higher odds of returning for follow-up than those with driving time <15 min, though the significance of this relationship disappeared after specific socioeconomic (SES) factors were included.Conclusions: Distance plays a significant role on follow-up attendance for pediatric patients with TBI. However, neighborhood SES may be an additional factor that influences the significance of the distance effect.Abbreviations: TBI: Traumatic brain injury; SES: socioeconomic status; ISS: Injury severity scale; AIS: Abbreviated injury scale.
