Telehealth appointments in a public developmental pediatrics clinic in Türkiye: a two-year observational study

To describe the use and appointment status of a nationally integrated telehealth pathway in a single-provider public developmental pediatrics clinic in Türkiye and to examine factors associated with telehealth appointment completion and cancellation. This retrospective single-center study included all telehealth appointments scheduled through Türkiye's national Central Physician Appointment System (Merkezi Hekim Randevu Sistemi: MHRS) using the Ministry of Health remote patient assessment module between 1 December 2023 and 1 December 2025. Telehealth appointments were physician-scheduled for selected clinical situations as a complement to prior in-person developmental assessment. Appointment indications, child and family characteristics, and telehealth appointment status categories (completed, cancelled, no-show) were described. Child-level multivariable binomial generalized linear models with logit link and robust standard errors were used to examine factors associated with telehealth completion and cancellation. A total of 526 telehealth appointments were scheduled for 380 children. Telehealth was most commonly used among children with prematurity or neonatal risk and for selected remote assessment purposes, including home-based naturalistic observation and caregiver-shared video review. Overall, 77.4% of telehealth appointments were completed, 20.5% were cancelled, and 2.1% were classified as no-show; among non-cancelled telehealth bookings, the no-show rate was 2.6% (11/418). In adjusted analyses, higher maternal education, paternal age 25-34 years, and travel distance ≥ 100 km were associated with higher cancellation and lower completion, whereas household income and rural residence were not independently associated.

In this public developmental pediatrics clinic, a physician-scheduled telehealth pathway integrated within the national appointment system was used as a supplementary service for selected follow-up, counselling, and remote observational assessment needs. Telehealth appointment completion was generally high, but families living ≥ 100 km from the clinic had less favorable appointment status patterns. These findings support telehealth as a complementary service model in developmental pediatrics and highlight the need to address barriers affecting attendance.

• Telehealth is increasingly used in developmental pediatrics, but evidence from routine public services, particularlyin low- and middle-income countries, remains limited. • Missed appointments can reduce usable clinical capacity in single-provider public subspecialty clinics.

• This study describes a two-year, physician-scheduled telehealth pathway integrated into Türkiye's CentralPhysician Appointment System within a public developmental pediatrics clinic. • Within the telehealth cohort, maternal education, paternal age 25-34 years, and travel distance ≥ 100 km were associated with less favorable appointment status patterns.