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Article
Facilitators and Barriers to Access to Pediatric Medical Services in a Community Hospital
Journal of Primary Care and Community Health
  • Qiyun Shi, Brookdale University Hospital and Medical Center
  • Fiorella Castillo, Brookdale University Hospital and Medical Center
  • Kusum Viswanathan, Brookdale University Hospital and Medical Center
  • Fernanda Kupferman, Brookdale University Hospital and Medical Center
  • Joy C. MacDermid, Western University
Document Type
Article
Publication Date
1-1-2020
URL with Digital Object Identifier
10.1177/2150132720904518
Abstract

© The Author(s) 2020. Background: Missed medical appointments decrease continuity of medical care, waste resources, and may affect health outcomes. We examined the factors associated with missed children’s supervision visits in Eastern Brooklyn, NY, USA. Methods: We surveyed guardians whose children received routine medical care at four pediatric clinics. Participants filled out a questionnaire that queried: demographics, food security, recent relocation, parental support of healthy behaviors, and length of knowing provider. Preexisting disease(s) and missed visits were retrieved from medical records. Regression analyses were used to determine factors that were associated with missing medical appointments. Results: Among 213 families, 33% faced food insecurity and 16.4% reported moving within the past 12 months. Forty percent of children missed at least 1 visit. Food insecurity (adjusted odds ratio [aOR] 2.3, 95% confidence interval [CI 1.0% to 5.2%) and recent relocation (aOR 1.8, 95% CI 1.1-3.4 were associated with missed health supervision visits, whereas greater parental healthy behaviors (aOR 0.5, 95% CI 0.3-0.9) and longer length of knowing provider (aOR 0.8, 95% CI 0.7-1.0) were associated with fewer missed appointments. Conclusion: This study indicates that social inequity may contribute to poor adherence to medical appointments through multiple mechanisms, including food insecurity, lack of social stability, and parental health behaviors. Multidimensional proactive prevention, and reactive tolerance should be considered as opportunities to mitigate the impact of social inequity on health outcomes.

Notes

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

This article was originally published as:

Shi, Q., Castillo, F., Viswanathan, K., Kupferman, F., & MacDermid, J. C. (2020). Facilitators and Barriers to Access to Pediatric Medical Services in a Community Hospital. Journal of Primary Care & Community Health. https://doi.org/10.1177/2150132720904518

Creative Commons License
Creative Commons Attribution-Noncommercial 4.0
Citation Information
Qiyun Shi, Fiorella Castillo, Kusum Viswanathan, Fernanda Kupferman, et al.. "Facilitators and Barriers to Access to Pediatric Medical Services in a Community Hospital" Journal of Primary Care and Community Health Vol. 11 (2020)
Available at: http://works.bepress.com/joy-macdermid/99/