Socioeconomic deprivation ups missed clinic visits for children

Children with medical complexity (CMC) living in areas of greater socioeconomic deprivation have an increased risk for missing patient-centered medical home (PCMH) visits, according to a study published online March 7 in Pediatrics.

Joanna Thomson, M.D., M.P.H., from the Cincinnati Children's Hospital Medical Center, and colleagues conducted a cross-sectional study involving 512 children aged younger than 18 years receiving care in a PCMH for CMC in 2016 to 2017. The association between area-level socioeconomic deprivation and health care utilization outcomes was examined.

The researchers found that the CMC lived in neighborhoods with varying degrees of socioeconomic deprivation (median, 0.32; full range, 0.12 to 0.82). No association was seen between area-level deprivation and emergency department visits, hospitalizations, or inpatient bed-days. However, for every 0.1 unit increase in the Deprivation Index, there was a 13% relative increase in the missed clinic visit rate.

"Our findings suggest that the social complexity in which CMC live influences other aspects of their health care, including visits to a specialized medical home," the authors write. "To ensure equitable care and outcomes for all CMC, health systems and providers should seek to understand and address any barriers to care arising from the socioeconomic context in which CMC live."

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