Identifying Risk Factors for Appointment No-Shows in a Pediatric Orthopaedic Surgery Clinic

Background: Appointment nonadherence in pediatric orthopaedic clinics negatively affects patient outcomes. While previous studies have examined risk factors for missed appointments, there is a lack of such research orthopaedics. This study tests the hypothesis that patients with greater socioeconomic are more likely to miss appointments. Our objective identify contributing Methods: A retrospective chart review was conducted all visits an outpatient clinic and affiliated Midwest level 1 academic hospital 2019. Possible covariates appointment attendance collected included sociodemographic information as age, gender (male/female), race/ethnicity (non-Hispanic White, Black, Hispanic/Latinx, Other), insurance (Commercial, Medicaid, Medicaid HMO, Other). The main outcome status, defined either “No-Show” or “Attended/Completed.” Using census data, Area Deprivation Index (ADI) determined matched case (“No-Show”) control sample quantify risk. Factors associated were analyzed logistic regression model. Results: Out 10,078 total encounters study, no-show rate 6.61%. Significant predictors race (p<0.001), type lag days between scheduling completion (p<0.001). In case-control sub-study, ADI positively increased odds making this model unique from other studies. Conclusions: data informs providers order individualize care plans based on specific needs. Efforts improve adherence may reduce poor health outcomes disparities underserved areas. Next steps include qualitative assessments articulate experience families who appointments develop standard accessible patient-centered care.