Sociodemographic Factors Associated With Adherence to Referrals From the Pediatric Emergency Department

Area of Science:

• Pediatric Emergency Medicine
• Health Services Research
• Health Disparities

Background:

• Outpatient referrals are crucial for continuity of care following emergency department (ED) visits.
• Barriers to post-ED referral attendance remain under-investigated, particularly in pediatric populations.

Purpose of the Study:

• To investigate the influence of sociodemographic variables on referral attendance rates after pediatric emergency department visits.
• To identify patient characteristics associated with missed outpatient appointments following ED care.

Main Methods:

• Retrospective cohort study of pediatric patients (0-17 years) with referrals from a children's hospital ED in 2016.
• Analysis of 6120 ED encounters and 822 outpatient referrals, counting multiple referrals per patient as distinct events.

Main Results:

• Referral attendance varied significantly by sociodemographic factors, including age, race, insurance status, and socioeconomic indicators of the patient's residence.
• Black females, patients with public insurance, and those from areas with high unemployment or low educational attainment showed decreased attendance.
• Attendance rates differed by specialty, with lower attendance for neurology referrals and higher attendance for orthopedic surgery referrals.

Conclusions:

• Significant disparities in outpatient referral attendance exist after pediatric emergency care.
• Sociodemographic and departmental factors play a role in missed follow-up appointments.
• Targeted resource allocation is needed to address these disparities and improve care for vulnerable pediatric populations.