Patient Factors Associated with Access to Outpatient Pediatric General Surgical Care in a Rural State

Abstract

Background: We sought to understand factors impacting timely access to outpatient pediatric general surgical care in a largely rural state. Methods: We conducted a multi-site retrospective cohort study, evaluating patients 100 miles away (OR = 1.55, p < 0.001) were more likely to not complete appointments. Patients with high household income (OR = 0.70, p = 0.009) and private insurance (OR = 0.60, p < 0.001) were less likely to not complete appointments. Delay to appointment was associated with race (p = 0.020). Patients with private insurance (p < 0.001) and higher income (p = 0.020) were more likely to undergo operation. Conclusion: Fifteen percent of patients referred for outpatient pediatric general surgical evaluation did not complete an appointment within one year. Race, household resources, insurance, and travel distance were associated with completing appointments. Information about groups that have disparate access to care will inform interventions to improve this access. Type of Study: Retrospective Cohort Study. Level of Evidence: III