Investigating and addressing missed care opportunities in a pediatric gastroenterology program
OA Version
Citation
Abstract
Missed care opportunities (MCOs), commonly referred to as clinic no-shows, pose a significant challenge in pediatric outpatient settings, affecting patient health outcomes and the efficiency of enterprise operations. MCO rates are prevalent across the healthcare landscape, ranging from 3.3% to 48.1%. The negative impact of MCOs can be particularly pronounced among younger patients and those with more complex medical needs. Infancy and childhood are critical periods for growth and development. Children from resource-limited and marginalized populations may be at greater risk for MCOs, subjecting them to structural disparities in healthcare access. This can result in long-term negative effects on linear growth, cognitive development, immunization status, and the management of chronic conditions. Furthermore, the financial implications of MCOs are significant, costing healthcare systems an estimated $50 billion annually in the United States.This thesis took a prospective, bottom-up approach to exploring these issues in an outpatient pediatric subspecialty program and discussed possible interventions for MCOs. Patients were directly called and surveyed in order to identify possible causes of MCOs and gain insight into how their life experiences might impact their ability to attend scheduled appointments. In addition to identifying possible causes of MCOs, the effectiveness of calling patients was evaluated as a potential form of appointment notification to improve attendance. Twenty-four of twenty-six patients who answered the phone attended their appointments, with two asking to reschedule to a time which they could confirm would allow them to attend their appointment with certainty. Addressing the causes of MCOs and implementing strategies to improve attendance could enhance patient outcomes and reduce healthcare costs.
Description
2025