Flores 2021


Year: 2021

Title: Analysis of socioeconomic and demographic factors and imaging exam characteristics associated with missed appointments in pediatric radiology

Country: United States

Age: Pediatric Only

Sex: All Sexes

Population: Multiple Groups

Care Setting: Outpatient Ambulatory and Primary Care

Clinical Setting: General Diagnostic Imaging

Data Level: Single Institution

Data Type: EHR

Data Source: Local data

Conclusion: Disparities In Some Minority Groups

Health OutComes Reported: No

Mitigation: No

Free Text Conclusion: Black/African-American race and Hispanic language were associated with an increased likelihood of imaging missed care opportunities.

Abstract: BACKGROUND: Missed appointments can have an adverse impact on health outcomes by delaying appropriate imaging, which can be critical in influencing treatment decisions. OBJECTIVE: To assess for socioeconomic and imaging exam factors associated with missed appointments among children scheduled for diagnostic imaging. MATERIALS AND METHODS: We retrospectively analyzed children (< 18 years) scheduled for outpatient diagnostic imaging during a 12-month period. In doing so, we obtained socioeconomic and radiology exam characteristics (modality, intravenous contrast administration, radiation and use of sedation) data from the electronic medical record. We employed multivariate logistic regression to assess the association of socioeconomic, demographic and imaging exam characteristics with imaging missed appointments. RESULTS: In total, 7,275 children met inclusion criteria. The mean age was 8.8 years (standard deviation [SD] = 6.2 years) and the study population consisted of 52% female gender, 69% White race, 38% adolescent age group and 32% with a median household income by ZIP-code category of <$50,000. Logistic regression showed increased likelihood of missed appointments among children of Black/African-American race (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.42.5); with insurance categories including Medicaid (OR=2.0; 95% CI=1.62.4), self-pay (OR=2.1; 95% CI=1.33.6) and other (OR=2.7; 95% CI=1.35.4); with < $50,000 median household income by ZIP-code category (OR=1.7; 95% CI=1.42.0); and with examination wait time of 721 days (OR=2.7; 95% CI=2.13.5) and > 21 days (OR=3.7; 95% CI=2.94.8). The use of radiation, intravenous contrast agent or sedation was not associated with increased likelihood of missed appointments. CONCLUSION: Expanding our knowledge of how different socioeconomic and imaging-related factors influence missed appointments among children can serve as a foundational step to better understand existing and emerging disparities and inform strategies to advance health equity efforts in radiology.