Social Determinants of Health and No-Show Clinic Appointments in Children with 22q11.2-Related Disorders.

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.