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Transportation Barriers in Pediatric Orthopaedic Clinic Visits
Maia H Hauschild1, Tishya A L Wren, Michelle Chavez
1From the Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, CA.
Insights
Transportation barriers like long travel times and difficult scheduling prevent children from attending orthopedic appointments. Improving access for mobility-impaired patients and simplifying scheduling can enhance clinic attendance.
Area of Science:
- Pediatric Orthopaedics
- Healthcare Accessibility
- Transportation Logistics
Background:
- Pediatric patients face unique challenges accessing specialized healthcare, particularly at major metropolitan orthopaedic centers.
- Transportation barriers can significantly impact continuity of care and treatment adherence for children with orthopaedic conditions.
Purpose of the Study:
- To identify transportation barriers encountered by pediatric patients traveling to a major metropolitan orthopaedic center.
- To determine how these barriers affect patient care and clinic attendance.
- To propose actionable changes to mitigate these issues and improve access to care.
Main Methods:
- A cross-sectional survey was administered to 107 caregivers of pediatric patients at a tertiary children's hospital.
- Logistic regression analysis was used to compare socioeconomic factors, transportation methods, and scheduling practices between caregivers who missed visits and those who did not.
- The study focused on patients attending an orthopaedic clinic in a large metropolitan area.
Main Results:
- 13% of caregivers reported missing one or more past orthopaedic clinic visits due to transportation issues or late arrival.
- Longer travel times (>45 minutes), delayed scheduling (>1 week), and difficulty scheduling appointments were significantly associated with missed visits.
- Nonambulatory status, use of mobility devices, and non-White race were also significantly linked to a history of missed appointments.
Conclusions:
- Travel time, scheduling difficulties, and patient ambulatory status are key factors influencing missed orthopaedic clinic visits.
- Socioeconomic factors, apart from those related to mobility and scheduling, were not significantly associated with nonattendance.
- Interventions should prioritize improving accessibility for patients with mobility limitations and streamlining appointment scheduling processes.
Objectives:
To identify what transportation barriers pediatric patients face when traveling to a major metropolitan orthopaedic center, how these barriers affect care, and what changes can be made to address this issue.
Study Design:
A cross-sectional transportation survey was administered to 107 caregivers of patients being seen in the orthopaedic clinic at a tertiary children's hospital in a large metropolitan area. Using logistic regression analysis, we compared socioeconomic characteristics, transportation methods, and scheduling practices among caregivers who reported missing at least one visit in the past and those who reported never missing a visit.
Results:
13% (14/108) of caregivers reported missing one or more past visits due to late arrival or transportation issues. Families that traveled more than 45 minutes to clinic (P = 0.04), waited more than one week to schedule a visit (P = 0.002), or reported difficulty scheduling a visit (P = 0.02) were significantly more likely to have a history of nonattendance. In addition, patients who were nonambulatory (P = 0.007), used a mobility device (P = 0.007), or were non-White (P < 0.05) were significantly more likely to have missed a visit.
Conclusion:
Travel time, difficult or delayed scheduling, and patient ambulatory status were all associated with missing orthopaedic clinic visits although other socioeconomic factors were not related. Interventions to improve orthopaedic clinic attendance should focus on promoting accessibility for patients with mobility limitations and encouraging simple and timely scheduling practices.
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