Pediatric Return Appointment Adherence for Child Welfare-Involved Children in Los Angeles California

• Published in: Maternal and child health journal 2016-02, Vol.20 (2), p.477-483
• Main Authors: Schneiderman, Janet U., Smith, Caitlin, Arnold-Clark, Janet S., Fuentes, Jorge, Kennedy, Andrea K.
• Format: Article
• Language: English
• Subjects: Adult; Age; Ambulatory Care Facilities; Analysis; Appointments and Schedules; Caregivers; Child; Child Welfare; Children; Chronic illnesses; Delivery of Health Care - organization & administration; Ethnicity; Families & family life; Female; Foster care; Gynecology; Health insurance; Health problems; Health services; Health services utilization; Hispanic Americans; Hispanic Americans - psychology; Hispanic Americans - statistics & numerical data; Humans; Los Angeles; Male; Maternal and Child Health; Medicaid; Medicine; Medicine & Public Health; Middle Aged; Patient Compliance - ethnology; Patient Compliance - psychology; Pediatrics; Population; Population Economics; Practice; Primary care; Primary health care; Public Health; Reminder Systems; Sociology; Surveys and Questionnaires; Telephone; United States
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-015-1845-4

Objectives This study of primarily Latino caregivers and Latino child welfare-involved children had the following aims: (1) explore the return appointment adherence patterns at a pediatric medical clinic; and (2) determine the relationship of adherence to return appointments and caregiver, child, and clinic variables. Methods The sample consisted of caregivers of child welfare-involved children who were asked to make a pediatric outpatient clinic return appointment ( N  = 87). Predictors included caregiver demographics, child medical diagnoses and age, and clinic/convenience factors including distance from the clinic to caregiver’s home, days until the return appointment, reminder telephone call, Latino provider, and additional specialty appointment. Predictors were examined using χ 2 and t tests of significance. Results Thirty-nine percent of all caregivers were nonadherent in returning for pediatric appointments. When return appointments were scheduled longer after the initial appointment, caregivers were less likely to bring children back for medical care. Conclusions The 39 % missed return appointment rate in this study is higher than other similar pediatric populations. Better coordination between pediatricians and caregivers in partnership with child welfare case workers is needed to ensure consistent follow-up regarding health problems, especially when appointments are not scheduled soon after the initial appointment.