You are here

  • Home
  • Archive
  • Volume 27, Issue 6
  • Transportation characteristics associated with non-arrivals to paediatric clinic appointments: a retrospective analysis of 51 580 scheduled visits

Article Text

Article menu
Download PDFPDF
Original research
Transportation characteristics associated with non-arrivals to paediatric clinic appointments: a retrospective analysis of 51 580 scheduled visits
  1. David J Wallace1,
  2. Kristin N Ray2,
  3. Abbye Degan2,
  4. Kristen Kurland3,
  5. Derek C Angus1,
  6. Ana Malinow2
  1. 1 Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  2. 2 Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  3. 3 School of Architecture, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr David J Wallace, Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; wallacedj{at}upmc.edu

Abstract

Background Prior work has not studied the effects of transportation accessibility and patient factors on clinic non-arrival.

Objectives Our objectives were: (1) to evaluate transportation characteristics and patient factors associated with clinic non-arrival, (2) to evaluate the comparability of bus and car drive time estimates, and (3) to evaluate the combined effects of transportation accessibility and income on scheduled appointment non-arrival.

Methods We queried electronic administrative records at an urban general pediatrics clinic. We compared patient and transportation characteristics between arrivals and non-arrivals for scheduled appointments using multivariable modeling.

Results There were 15 346 (29.8%) clinic non-arrivals. In separate car and bus multivariable models that controlled for patient and transit characteristics, we identified significant interactions between income and drive time, and clinic non-arrival. Patients in the lowest quartile of income who were also in the longest quartile of travel time by bus had an increased OR of clinic non-arrival compared with patients in the lowest quartile of income and shortest quartile of travel time by bus (1.55; P<0.01). Similarly, patients in the lowest quartile of income who were also in the longest quartile of travel time by car had an increased OR of clinic non-arrival compared with patients in the lowest quartile of income and shortest quartile of travel time by car (1.21, respectively; P<0.01).

Conclusions Clinic non-arrival is associated with the interaction of longer travel time and lower income.

  • ambulatory care
  • health services research
  • primary care

https://doi.org/10.1136/bmjqs-2017-007168

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Handling editor Kaveh G Shojania

    • Contributors All authors contributed to study design, analysis, interpretation of findings and manuscript development.

    • Funding The article is funded by Agency for Healthcare Research and Quality (K12HS022989) and National Institutes of Health National Heart, Lung and Blood Institute (K08HL122478).

    • Competing interests None declared.

    • Ethics approval This project was approved by the human subjects research board at the University of Pittsburgh School of Medicine.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The primary data for this study were an electronic record of scheduled paediatric clinic appointments and attendance. For the years of evaluation, with the exception of specified encounter exclusions, we analysed the entire cohort. There are no unpublished data from the study.

    Linked Articles