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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.
Background:
Patient non-attendance at pediatric ambulatory visits disrupts clinic workflow and limits access to care, causing financial losses for the healthcare system.
Methods:
A cross-section of 487 patients scheduled from January 2023 to July 2023, 4 years of age or less, were analyzed for descriptive patient demographics and the first scheduled appointment during the study window. The univariate analysis compared groups of attendance and non-attendance with multivariate logistic regression examining relationships between variables of interest.
Results:
The overall missed opportunities rate was 30.2% (n = 147). Lead time, marginalized populations, use of prescription medications, and previous non-attendance were independent determinants of non-attendance using a multivariate logistic model.
Discussion:
The primary modifiable driver of patient non-attendance was appointment lead time. Several non-modifiable determinants of non-attendance could provide focus areas for targeted interventions from missed opportunity appointments. Reducing non-attendance should focus on improving access to care for vulnerable pediatric patients from under-resourced communities.
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