No-Show Clinic Appointments and the Social Determinants of Health in Pediatric Tracheostomy Patients

Sunday, September 29, 2024

8:24 AM – 8:30 AM EDT

Location: MBCC, 225

Disclosure(s):

Antonio A. Bon Nieves, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Adrian Williamson, MD, IV:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Daniel R. Jensen, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jason R. Brown, DO:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: The health and wellbeing of pediatric tracheostomy patients may be influenced by socioeconomic factors, which can significantly shape their healthcare experiences, access to services, and overall quality of life. This study aims to identify what social determinants of health correlate with clinic no show in pediatric tracheostomy patients.

Methods: A retrospective chart review was performed on pediatric tracheostomy patients at a tertiary care pediatric hospital. Patients who had two or more scheduled appointments in the multidisciplinary tracheostomy clinic (MTC) and not lost to follow-up were included. Socioeconomic data such as median income, fraction of population in assisted income, fraction of the population below the poverty line, and deprivation index were gathered based on the patient’s home address using GeoMarker. Missed appointments (MA) were defined as absence from an appointment due to cancellation or not showing up.

Results: A total of 112 patients met the inclusion criteria. Most were male (62.5%), White (61.6%), and non-Hispanic (92.0%). The median percentage of MA per patient was 25.3% (IQR: 18.0-34.1%) for all visits and 17.9% (IQR: 8.3-29.1%) for MTC. There was a positive correlation between the fraction of population on assisted income (r = 0.23, p = 0.014), population below poverty line (r = 0.2, p = 0.034), and deprivation index (r = 0.21, p = 0.026) with percentage of “no show” to MTC. There was a negative correlation between the median household income (r = -0.2136, p = 0.024) and fraction of the population with high school education (r = -0.22, p = 0.019) with the percentage of “no show” to MTC.

Conclusions: These findings demonstrate the potential impact of these social determinants of health on missed clinic appointments among pediatric tracheostomy patients. Moreover, this study offers insights that could aid in identifying patients vulnerable to missed clinic appointments to assist in developing targeted interventions to enhance clinic attendance and ultimately improve patient outcomes.

Presenting Author(s)

Antonio A. Bon Nieves, BS

Clinical Research Fellow
University of Kansas Medical Center
San Juan, PR, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Adrian Williamson, IV, MD

Assistant Professor
Arkansas Children’s Hospital
Little Rock, AR, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
AN

Andrea T. Nguyen, BS

Medical Student
Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA
Wichita, KS, United States

Disclosure information not submitted.
MT

Meghan Tracy

Disclosure information not submitted.
DJ

Daniel R. Jensen, MD

Assistant Professor
Children's Mercy Hospital
Overland Park, KS, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Jason R. Brown, DO

Assistant Professor
Children's Mercy Hospital
Kansas City, MO, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.