Telephone triage does not improve attendance rates in a paediatric audiology outpatient service
Michelle A Pokorny1, Renee A Hislop2, Elizabeth A L Holt3
1Paediatric Audiologist, Audiology Department, Counties Manukau DHB, 901 Great South Road, Manukau City Centre, Auckland, New Zealand.
Insights
Clinician-led telephone consultations during COVID-19 lockdown did not improve paediatric audiology appointment attendance. Māori and Pacific children had lower attendance rates, highlighting ethnic disparities in healthcare access.
Area of Science:
- Paediatric Audiology
- Public Health
- Health Services Research
Background:
- The COVID-19 pandemic necessitated rapid shifts in healthcare delivery, including the implementation of telephone consultations.
- Understanding the impact of these changes on vulnerable populations, such as Māori and Pacific families, is crucial for equitable service provision.
Purpose of the Study:
- To evaluate the effectiveness of clinician-led telephone consultations on appointment attendance in a paediatric audiology service during the New Zealand COVID-19 lockdown.
- To specifically assess the impact on Māori and Pacific families.
Main Methods:
- A retrospective clinical audit was conducted at Counties Manukau Health, analyzing children over 3 years old on the audiology waiting list.
- Binary logistic regression was used to examine the association between appointment attendance and factors including ethnicity, waiting times, socio-economic status, and telephone consultation contact.
Main Results:
- Telephone consultations were attempted with 208 families (59% participation).
- Overall appointment attendance rates showed no significant difference between those who had telephone consultations and those who did not (77.5% vs. 77.8%).
- Māori and Pacific children were significantly less likely to attend appointments (68% and 64% respectively) after adjusting for covariates, compared to NZ European children. Longer waiting times were associated with decreased attendance.
Conclusions:
- Appointment attendance in paediatric audiology is influenced by ethnicity and waiting times.
- Clinician-led telephone consultation demonstrated limited benefit in improving overall attendance rates or addressing ethnic disparities in this setting.
- Further strategies are needed to ensure equitable access and attendance for all children, particularly those from Māori and Pacific backgrounds.
Aims:
To investigate the impact of clinician-led telephone consultation during the New Zealand COVID-19 lockdown on subsequent appointment attendance in a paediatric audiology service, particularly for Māori and Pacific families.
Methods:
A retrospective clinical audit at Counties Manukau Health of all children (>3 years old) on the audiology waiting list. Binary logistic regression analysis tested for association of appointment attendance following attempted audiologist-led telephone consultation, with ethnicity, waiting times, socio-economic deprivation levels and telephone consultation contact.
Results:
Of 349 eligible children, 208 families participated in telephone consultations (59%). Ten percent of those contacted were able to be discharged as no longer requiring care. There were no differences in attendance rates between those who had participated in telephone consultation and those who had not (77.5% versus 77.8%). Pacific and Māori children were 68% and 64% less likely to attend appointments after adjusting for socio-economic deprivation level, waiting time and telephone consultation compared to NZ European children. Longer waiting times were significantly associated with decreased attendance rates.
Conclusions:
Attendance was found to be associated with ethnicity and waiting times. Telephone consultation did not improve attendance rates overall nor for ethnicity subgroups. It is therefore concluded that telephone consultation was found to be of only limited benefit in paediatric audiology services.
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