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Missed Appointments at a Child Development Centre and Barriers to Access Special Needs Services for Children in Klang
Fariza Fadzil1,2, Idayu Badilla Idris1, Norazlin Kamal Nor3
1Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia.
Insights
Missed appointments for children with special needs are common, with forgetfulness being a key factor. Longer follow-up durations and male caregivers are associated with higher missed appointment rates.
Area of Science:
- Pediatrics
- Developmental Disabilities
- Healthcare Accessibility
Background:
- Regular medical appointments are crucial for children with special needs, ensuring continuity of care and overall well-being.
- Missed appointments can disrupt treatment plans and negatively impact health outcomes for this vulnerable population.
- Understanding barriers to care is essential for improving service delivery.
Purpose of the Study:
- To determine the prevalence of missed clinic appointments among children with special needs.
- To identify factors associated with missed appointments and barriers to accessing services.
- To explore caregiver suggestions for enhancing appointment adherence and service accessibility.
Main Methods:
- An explanatory sequential mixed methods study was conducted.
- Data were collected from 197 caregivers of children with developmental disabilities (up to 17 years old).
- Statistical analysis included bi-variable and logistic regression, supplemented by qualitative insights.
Main Results:
- 31.5% of caregivers reported missing at least one clinic appointment.
- Forgetfulness was the most common reason for missed appointments.
- Follow-up duration exceeding 6 years and being a male caregiver significantly increased the risk of missed appointments (OR=2.67).
- Perceived barriers included transportation, caregiver-related issues, child-specific factors, and healthcare service limitations.
Conclusions:
- Forgetfulness, longer follow-up durations, and caregiver gender are significant factors influencing missed appointments.
- Transportation, caregiver burden, child-related issues, and healthcare system challenges impede access to services.
- Targeted interventions addressing these factors are needed to improve appointment adherence and service accessibility for children with special needs.
Abstract:
Attending appointments is vital for children with special needs, as such appointments involve long-term interdisciplinary care to ensure continuity of care and improve health and well-being. This study was performed to determine the prevalence of missed clinic appointments and identify the factors among those who have ever missed appointments and barriers of access to children's special needs services at the Child Development Centre (CDC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Moreover, suggestions for improvement from the caregivers' perspectives were explored. This is an explanatory sequential mixed methods study among caregivers of children with developmental disabilities aged up to 17 years old. Of 197 caregivers, 62 (31.5%) had missed clinic appointments. Forgetfulness was the most frequently cited reason. The bi-variable analysis showed significant differences in missed appointment rates by gender of caregivers and duration of follow-up. The final logistic regression model demonstrated that, when combined with the effect of being a male caregiver as an independent variable, follow-up duration of more than 6 years increased 2.67 times the risk of missing an appointment. Caregivers' perceived barriers were transportation, caregiver, child and healthcare services factors. Policies and strategic plans should be focused on key findings from these factors to improve appointment adherence and accessibility to services for children with special needs.
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