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Benchmarking non-attendance patterns in paediatric medical imaging: A retrospective cohort study spotlighting First
M Cleary1, C Edwards2, J Mitchell-Watson3
1School of Pharmacy, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
Insights
Non-attendance at pediatric medical imaging (MI) appointments is common, particularly for older males, First Nations children, and those in disadvantaged areas. Addressing these factors can improve healthcare access for vulnerable children.
Area of Science:
- Pediatric Radiology
- Healthcare Access
- Health Disparities
Background:
- Non-attendance at medical imaging (MI) appointments leads to healthcare inefficiencies and increased costs.
- Understanding factors influencing missed appointments is crucial for optimizing healthcare delivery for children.
Purpose of the Study:
- To identify demographic, socioeconomic, and appointment-related factors associated with non-attendance at pediatric MI appointments.
- To inform targeted interventions for improving appointment adherence in vulnerable pediatric populations.
Main Methods:
- Retrospective cohort study of 17,962 scheduled MI appointments for children at an Australian tertiary pediatric hospital (2022).
- Analysis included chi-squared and logistic regression, integrating socioeconomic data via postcodes.
- Key variables examined: gender, age, Indigenous status, socioeconomic status, and imaging modality.
Main Results:
- Overall non-attendance rate was 6.2%.
- Higher non-attendance observed in older children, males, First Nations children (OR 2.54), and those from disadvantaged areas.
- Bone mineral densitometry had the highest non-attendance rate (19.4%).
Conclusions:
- Older male gender, Indigenous status (First Nations Australian), and socioeconomic disadvantage are significant predictors of non-attendance.
- These findings highlight critical areas for developing targeted strategies to improve healthcare access for children requiring medical imaging.
Introduction:
Non-attendance at Medical Imaging (MI) appointments can result in inefficiencies in healthcare resource allocation, increased financial burdens, and lead to potential barriers to effective healthcare delivery. We evaluated factors associated with non-attendance of MI appointments for children including variables: gender; age groups; residential postcodes; Indigenous status; appointment dates; appointment reminders and socio-economic status.
Method:
Retrospective cohort study of children with scheduled MI appointments at a Tertiary paediatric hospital in Australia, between January and December 2022. Data were extracted from the Radiology Information System and integrated with socio-economic census data through linking with postcode. Chi-squared, and logistic regression analysis were performed to identify significant predictors of non-attendance.
Results:
Out of 17,962 scheduled outpatient appointments, 6.2 % did not attend. Males were less likely to attend than females (7.3 % vs. 5.8 %; p < 0.001). Older children had the highest frequency of non-attendance (p < 0.001). First Nations identified children had a higher likelihood of non-attendance at 14.5 % compared to non-First Nations at 5.8 %, and the odds ratio (OR) of First Nation children not attending was 2.54 (CI 2.13-3.03; p < 0.001) higher than non-First Nations children. Children from areas of disadvantage were less likely to attend (p < 0.001). Bone mineral densitometry had the highest odds of non-attendance (19.4 % of bookings) compared to other imaging modalities (p < 0.001).
Conclusion:
The following characteristics were associated with non-attendance: older male gender, residing in areas of socio-economic disadvantage, or identifying as First Nations Australians. By reviewing these findings with the cultural and professional experience of our Indigenous co-author, we have identified some strategies for improving attendance amongst First Nations children.
Implications For Practice:
Factors associated with non-attendance, or "missed opportunities for care", provide opportunities for intervention to improve attendance for vulnerable groups of children who require medical imaging.
