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Disparities in utilization of outpatient surgical care among children

Ryan J Powers1, Ali A Mokdad2, Liliana E Pezzin3

  • 1Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

Surgery
|June 25, 2021
PubMed

Insights

Children from disadvantaged neighborhoods, Black children, and those with public insurance are more likely to miss pediatric surgery clinic appointments. These disparities highlight access challenges in pediatric surgical care utilization.

Area of Science:

  • Pediatric Surgery
  • Health Services Research
  • Health Disparities

Background:

  • Disparities exist in outpatient pediatric surgical care utilization.
  • Socioeconomic disadvantage at the neighborhood level may impact access to care for children.

Purpose of the Study:

  • Quantify disparities in outpatient pediatric surgical care utilization.
  • Examine the association between neighborhood socioeconomic disadvantage and access to care.

Main Methods:

  • Analysis of clinic "no-shows" for children scheduled between 2017-2019 at pediatric surgery clinics.
  • Used multivariable logistic regression to assess the impact of Area Deprivation Index and patient factors on no-shows.
  • Subgroup analysis focused on postoperative clinic visits after common pediatric surgeries.

Main Results:

  • 16% of 10,162 patients had at least one no-show.
  • Higher Area Deprivation Index, Black race, and public insurance were significantly associated with increased no-show rates.
  • 20% of children undergoing appendectomy or hernia repair were no-shows for postoperative visits.

Conclusions:

  • Race, insurance status, and neighborhood socioeconomic disadvantage are linked to disparities in pediatric surgical care access.
  • Access challenges for disadvantaged children may contribute to disparate health outcomes.
Abstract

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