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Missed Opportunities in Pediatric Feeding Clinic: A Multivariate Analysis

Amy Ricketts1, Dana M Bakula2, Sarah Edwards3

  • 1Remote Health Solutions, Children's Mercy Hospital, Kansas City, MO; School of Nursing and Health Sciences, University of Missouri-Kansas City, Kansas City, MO; Division of Gastroenterology, Children's Mercy Hospital, Kansas City, MO.

Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners
|September 24, 2025
PubMed

Insights

Pediatric appointment no-shows, at 30.2%, are linked to longer wait times and marginalized groups. Reducing missed pediatric appointments requires addressing lead time and supporting vulnerable populations.

Area of Science:

  • Pediatric healthcare access
  • Healthcare management
  • Public health

Background:

  • Patient non-attendance at pediatric ambulatory visits disrupts clinic workflow.
  • Missed appointments limit patient access to essential healthcare services.
  • No-shows result in significant financial losses for healthcare systems.

Purpose of the Study:

  • To identify key determinants of patient non-attendance in pediatric ambulatory care.
  • To analyze factors influencing missed appointments in young children.
  • To inform strategies for reducing no-show rates and improving healthcare access.

Main Methods:

  • Analysis of 487 pediatric patients (≤4 years) scheduled between January and July 2023.
  • Descriptive demographic analysis and examination of appointment lead time.
  • Univariate and multivariate logistic regression to identify non-attendance predictors.

Main Results:

  • The overall missed opportunities rate was 30.2% (147 patients).
  • Independent determinants of non-attendance included appointment lead time, marginalized populations, medication use, and prior no-shows.
  • Multivariate logistic regression identified significant relationships between these variables and missed appointments.

Conclusions:

  • Appointment lead time is the primary modifiable factor contributing to pediatric non-attendance.
  • Non-modifiable factors highlight areas for targeted interventions to reduce missed appointments.
  • Strategies to decrease no-shows should prioritize improving access for vulnerable pediatric patients in under-resourced communities.
Abstract

Keywords:
Ambulatory caregastroenterologyno-show patientspatient compliance

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