478 - Screening Rates for School Absenteeism in an Urban FQHC

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 478
Publication Number: 478.217

Jacqueline Antoun, Children's Hospital Los Angeles, Los Angeles, CA, United States; Kevin Fang, Children's Hospital Los Angeles, Los Angeles, CA, United States; Victoria Goldman, Children’s Hospital Los Angeles, Los Angeles, CA, United States

Presenting Author(s)

Jacqueline Antoun, MD (she/her/hers)

Resident
Children's Hospital Los Angeles
Los Angeles, California, United States

First Author(s)

Kevin Fang, MD MPH (he/him/his)

Assistant Clinical Professor of Pediatrics
Children's Hospital Los Angeles
Los Angeles, California, United States

Background: Chronic school absenteeism ( >10% of missed school days) affects more than 6.5 million school-age children each year and one in ten students in California in 2019. It is an important predictor of school failure, and is linked with numerous adult health outcomes including substance use, increased cardiovascular disease, and higher mortality. It is also correlated with childhood diseases including asthma, obesity, and vaccination status. Significantly higher rates of absenteeism are also seen among students in minority groups and lower-income families. Unfortunately, little data on implementation and value of standardized screening for absenteeism in healthcare settings exists.

Objective: Analyze data following implementation of a chronic absenteeism screening tool at a Federally Qualified Health Center.

Design/Methods: In July 2021, a screening tool for chronic absenteeism was inserted into the well-child check template of an FQHC tied to an urban freestanding children’s hospital in California. All encounters with a 99394 CPT code from October 2022 were analyzed. Provider (attending vs resident) and patient demographics (age, race/ethnicity, insurance, medical history) were recorded along with responses to the screening tool ( >=2 absences in the last month was noted as positive). Chi-square analyses were performed.

Results: 335 records were queried and 38 were excluded due to repeat entry or improper CPT code. 71.7% (n=213) of patients were screened with similar rates between residents (67.4%) and attendings (72.5%) (p=0.47). Of those screened, 9.4% were Non-Hispanic White, 3.2% Black, 2.8% Asian, and 79.8% Hispanic/Latino. 90.6% were on public insurance. 13.2% (n=28) of responses screened positive for chronic absenteeism. 14.0% (n=25) of non-White vs 5% (n=1) of White patients screened positive (p=0.436). 13.7% (n=27) of those on public insurance vs 10% (n=1) of those on private insurance screened positive (p=0.889). 14.3% (n=4) of those screened positive had asthma as a listed diagnosis vs 8.4% (n=24) of those who screened negative (p=0.512).

Conclusion(s): Risk of chronic absenteeism among our predominantly minority and lower-income patient population is higher than the true rate of ~10% in the state. No significant differences in risk were seen based on ethnicity, insurance status nor asthma, however, these may be a product of insufficient power as minority patients, those on public insurance, and those with asthma had higher rates of positive screens. Next steps are to analyze additional months, and to compare data from one year to another.