Missed Opportunities in Pediatric Feeding Clinic: A Multivariate Analysis.

Creator(s)

Amy Ricketts, Children's Mercy Kansas CityFollow
Dana Bakula, Children's Mercy HospitalFollow
Sarah T. Edwards, Children's Mercy HospitalFollow
Kristina Nash, Children's Mercy Kansas CityFollow
April Escobar, Children's Mercy Kansas CityFollow
Rachel Graham, Children's Mercy Kansas CityFollow
Ryan Thompson, Children's Mercy Kansas CityFollow
Sarah Bullard, Children's Mercy Kansas CityFollow
Julianne Brogren, Children's Mercy Kansas CityFollow
Keith Feldman, Children's Mercy HospitalFollow
Lori A. Erickson, Children's Mercy Kansas CityFollow

Document Type

Article

Publication Date

11-2025

Identifier

DOI: 10.1016/j.pedhc.2025.07.001

Abstract

BACKGROUND: Patient non-attendance at pediatric ambulatory visits disrupts clinic workflow and limits access to care, causing financial losses for the healthcare system.

METHODS: A cross-section of 487 patients scheduled from January 2023 to July 2023, 4 years of age or less, were analyzed for descriptive patient demographics and the first scheduled appointment during the study window. The univariate analysis compared groups of attendance and non-attendance with multivariate logistic regression examining relationships between variables of interest.

RESULTS: The overall missed opportunities rate was 30.2% (n = 147). Lead time, marginalized populations, use of prescription medications, and previous non-attendance were independent determinants of non-attendance using a multivariate logistic model.

DISCUSSION: The primary modifiable driver of patient non-attendance was appointment lead time. Several non-modifiable determinants of non-attendance could provide focus areas for targeted interventions from missed opportunity appointments. Reducing non-attendance should focus on improving access to care for vulnerable pediatric patients from under-resourced communities.

Journal Title

Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners

Volume

39

Issue

6

First Page

882

Last Page

889

MeSH Keywords

Humans; Male; Female; Cross-Sectional Studies; Appointments and Schedules; Infant; Child, Preschool; Multivariate Analysis; Health Services Accessibility; Ambulatory Care Facilities; No-Show Patients; Patient Compliance; Infant, Newborn

PubMed ID

40990888

Keywords

Ambulatory care; gastroenterology; no-show patients; patient compliance

Recommended Citation

Ricketts A, Bakula DM, Edwards S, et al. Missed Opportunities in Pediatric Feeding Clinic: A Multivariate Analysis. J Pediatr Health Care. 2025;39(6):882-889. doi:10.1016/j.pedhc.2025.07.001