Missed Opportunities in Pediatric Feeding Clinic: A Multivariate Analysis.

IF 1.8 4区医学 Q2 HEALTH POLICY & SERVICES

Journal of Pediatric Health Care Pub Date : 2025-09-24 DOI:10.1016/j.pedhc.2025.07.001

Amy Ricketts, Dana M Bakula, Sarah Edwards, Kristina Nash, April Escobar, Rachel Graham, Ryan Thompson, Sarah Bullard, Julianne Brogren, Keith Feldman, Lori A Erickson

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引用次数: 0

Abstract

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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儿科喂养门诊错失机会：多变量分析。

背景：患者不出席儿科门诊就诊扰乱了临床工作流程，限制了获得护理的机会，给医疗保健系统造成了经济损失。方法：对2023年1月至2023年7月487例年龄在4岁或以下的患者进行横断面分析，分析描述性患者人口统计学特征和研究窗口期间的首次预约。单变量分析比较出勤组和不出勤组，多变量逻辑回归检验感兴趣变量之间的关系。结果：总体错失率为30.2% （n = 147）。使用多变量logistic模型，前置时间、边缘人群、使用处方药和以前未出勤是未出勤的独立决定因素。讨论：患者不出席的主要可改变的驱动因素是预约提前时间。缺席的几个不可改变的决定因素可以为错过机会的预约提供有针对性的干预措施的重点领域。减少缺勤的重点应放在改善资源不足社区的弱势儿科患者获得护理的机会上。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric Health Care NURSING-PEDIATRICS

CiteScore

3.40

自引率

10.70%

发文量

140

审稿时长

24 days

期刊介绍： The Journal of Pediatric Health Care, the official journal of the National Association of Pediatric Nurse Practitioners, provides scholarly clinical information and research regarding primary, acute and specialty health care for children of newborn age through young adulthood within a family-centered context. The Journal disseminates multidisciplinary perspectives on evidence-based practice and emerging policy, advocacy and educational issues that are of importance to all healthcare professionals caring for children and their families.