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Social Determinants of Health and No-Show Clinic Appointments in Children with 22q11.2-Related Disorders
Adrian Williamson1,2,3, Antonio A Bon Nieves4,5, Meghan Tracy1
1Division of Otolaryngology, Children's Mercy Hospital, Kansas City, MO, USA.
Insights
Socioeconomic factors like ethnicity and income influence clinic no-show rates in children with 22q11.2 deletion syndrome (22q11.2DS). Addressing these disparities can improve healthcare access and patient outcomes for this vulnerable population.
Area of Science:
- Pediatric healthcare
- Genetics and rare diseases
- Health services research
Background:
- Children with 22q11.2 deletion syndrome (22q11.2DS) face complex medical needs requiring multidisciplinary care.
- Healthcare access and outcomes in 22q11.2DS may be affected by socioeconomic and demographic factors.
- Understanding factors contributing to missed appointments is crucial for optimizing care delivery.
Purpose of the Study:
- To identify socioeconomic, racial, and ethnic factors associated with missed clinic appointments in pediatric patients with 22q11.2DS.
- To investigate potential healthcare disparities in appointment attendance for children with 22q11.2DS.
- To inform the development of targeted interventions to improve clinic visit adherence.
Main Methods:
- Retrospective cohort study of pediatric patients diagnosed with 22q11.2DS at a tertiary care hospital.
- Socioeconomic variables were determined by cross-referencing patient addresses with the GeoMarker database.
- Clinic no-show rates were analyzed for associations with socioeconomic status, ethnicity, and race.
Main Results:
- A total of 198 patients with 22q11.2DS were included, accounting for 2049 visits to the 22q11.2 multidisciplinary clinic (22qMDC) and 8708 other clinic visits.
- The median no-show rate for 22qMDC was 0%, while other clinic appointments had a median no-show rate of 4.35%.
- Hispanic or Latino ethnicity, lower household income, lower high school education levels, higher poverty rates, and reliance on assisted income were significantly associated with higher no-show rates.
Conclusions:
- Socioeconomic factors demonstrably influence clinic appointment attendance in children with 22q11.2DS.
- Identifying these disparities is essential for developing targeted strategies to enhance healthcare engagement.
- Improving clinic attendance can lead to better health outcomes for children with 22q11.2DS.
Abstract:
ObjectiveChildren with 22q11.2 deletion syndrome (22q11.2DS) present with complex medical challenges and often are followed by multiple specialists. Healthcare for these patients may be influenced by demographic and socioeconomic factors. This study's aim is to identify factors correlated with no-show clinic visits for these children.DesignRetrospective cohort studySettingTertiary care hospitalParticipantsPediatric patients with a diagnosis of 22q11.2DS. Patients without appointment attendance or socioeconomic data were excluded.InterventionsNoneMain Outcomes and MeasuresTo identify potential healthcare disparities, the patient's home address was cross-referenced with the GeoMarker database to define socioeconomic variables. We analyzed the rate of no-show clinic appointments to identify associations with socioeconomic, racial, or ethnic factors.ResultsOf the 198 patients with 22q11.2DS were included in this study. These patients were scheduled for 2049 visits with the 22q11.2 multidisciplinary clinic (22qMDC) and 8708 additional clinic visits within the institution. The median 22qMDC no-show rate was 0% [interquartile range-IQR: 0, 9.78] and 4.35% [IQR: 0, 15.00] for other clinic appointments. Socioeconomic factors associated with clinic no-show included Hispanic or Latino ethnicity, lower median household income, lower fraction of population with high school diploma, higher fraction of population below the poverty line, and higher fraction of population that required assisted income.ConclusionsThese findings highlight potential influences of socioeconomic factors on no-show clinic appointments in children with 22q11.2DS. These factors can be used to develop targeted interventions aimed at improving clinic attendance and ultimately elevating patient outcomes.
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