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Health Inequities

Association of Race and Socioeconomic Disadvantage With Missed Telemedicine Visits for Pediatric Patients During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Pediatrics

Published Online: May 23, 2022

Research Letter

Article Information and Disclosures

Evan Brociner, BS¹;

Kun-Hsing Yu, MD, PhD²;

Isaac S. Kohane, MD, PhD²;

McGreggor Crowley, MD¹

Author Affiliations

¹Division of Gastroenterology, Hepatology, and Nutrition, Boston Children’s Hospital, Boston, Massachusetts
²Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts

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Missed scheduled clinic appointments (ie, no-shows) are more common among uninsured patients from racial and ethnic minority groups living in economically disadvantaged areas and contribute to poorer health outcomes.¹^- 3 In the pediatric population, the implications of telemedicine for no-show rates have not been adequately explored despite the widespread adoption of telemedicine during the COVID-19 pandemic. The aim of this study was to ascertain whether patient race and ethnicity and level of socioeconomic disadvantage were associated with no-show rates for in-person and telemedicine clinic visits.

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Article Information

Accepted for Publication: January 26, 2022.

Published Online: May 23, 2022. doi:10.1001/jamapediatrics.2022.1510

Corresponding Author: McGreggor Crowley, MD, Division of Gastroenterology, Hepatology, and Nutrition, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 (paul.crowley@childrens.harvard.edu).

Author Contributions: Mr Brociner and Dr Crowley had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Brociner, Yu, Crowley.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Brociner, Crowley.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Brociner, Yu, Crowley.

Obtained funding: Crowley.

Administrative, technical, or material support: Yu, Crowley.

Supervision: Kohane, Crowley.

Conflict of Interest Disclosures: Dr Yu reported receiving grants from the National Institutes of Health National Institute of General Medical Sciences and being an inventor of US patent 16/179,101, that is, quantitative pathology analysis and diagnosis using neural networks, assigned to Harvard University outside the submitted work. No other disclosures were reported.

References

Guzek LM , Fadel WF , Golomb MR . A pilot study of reasons and risk factors for “no-shows” in a pediatric neurology clinic. J Child Neurol. 2015;30(10):1295-1299. doi:10.1177/0883073814559098 PubMed Google Scholar Crossref

Kemp MT , Liesman DR , Brown CS , et al. Factors associated with increased risk of patient no-show in telehealth and traditional surgery clinics. J Am Coll Surg. 2020;231(6):695-702. doi:10.1016/j.jamcollsurg.2020.08.760 PubMed Google Scholar Crossref

Miller AJ , Chae E , Peterson E , Ko AB . Predictors of repeated “no-showing” to clinic appointments. Am J Otolaryngol. 2015;36(3):411-414. doi:10.1016/j.amjoto.2015.01.017 PubMed Google Scholar Crossref

American Community Survey. US Census Bureau. Updated March 28, 2022. Accessed January 2, 2022. https://www.census.gov/programs-surveys/acs

Haynes SC , Marcin JP , Dayal P , Tancredi DJ , Crossen S . Impact of telemedicine on visit attendance for paediatric patients receiving endocrinology specialty care. J Telemed Telecare. 2020;X20972911. Published online November 23, 2020. doi:10.1177/1357633X20972911 PubMed Google Scholar Crossref

Crossen SS , Marcin JP , Qi L , et al. Home visits for children and adolescents with uncontrolled type 1 diabetes. Diabetes Technol Ther. 2020;22(1):34-41. doi:10.1089/dia.2019.0214 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.