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Original Research

Program: Section on Orthopaedics

O3240: Transportation Barriers in Pediatric Orthopaedic Clinic Visits

Sunday, October 22, 2023
9:35 AM – 9:39 AM US EDT
Location: H3001: Section on Orthopaedics Program: Day 2
Oral Presentation
Background: Lack of transportation is a well-established barrier to accessing health care. Studies have identified lower income and longer travel time as factors contributing to missed medical appointments for pediatric patients. The purpose of this study was to identify transportation barriers and other factors contributing to missed pediatric outpatient orthopaedic clinic visits.

Methods: A prospective transportation survey was administered to a convenience sample of caregivers of patients being seen at a tertiary pediatric hospital between October 2020 and November 2021. Logistic regression analysis was used to compared demographic and socioeconomic characteristics, transportation methods, and scheduling practices among caregivers who reported missing at least one visit in the past and those who reported never missing a visit.

Results: Of 107 families who completed the survey, 25% (27/107) had missed at least one clinic visit due to late arrival (n=14) and/or transportation issues (n=25). Missed visits were more likely for patients who used a mobility device (OR 3.7, p=0.005), had difficulty scheduling a visit (OR 3.2, p=0.01), waited more than one week to schedule a visit (OR 2.9, p=0.02), or traveled more than 45 minutes to the appointment (OR 3.1, p=0.04). The likelihood of missing a visit was not affected by marital status, employment, insurance type, patient age, parent age, or primary language. There was a trend towards lower odds of patients missing a visit if they traveled in their personal car (OR 0.38, p=0.07), though this did not reach statistical significance.

Conclusion: Inconsistent with existing literature, socioeconomic factors such as primary language, payor status, education level, and age were not predictive of clinic attendance history. In addition, mode of travel and travel time were not significantly associated with missing a visit in the past. Interventions to improve orthopaedic clinic attendance should focus on promoting accessibility for patients who use mobility devices and encouraging more
effective scheduling practices.