591 - Association Between Missed Appointments and Hospitalization for Child Physical Abuse

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 591
Publication Number: 591.103

Rebecca Callahan, Baylor College of Medicine, San Antonio, TX, United States; Alicia Johns, Geisinger, Danville, PA, United States; Amanda Young, Geisinger, Danville, PA, United States; Chris Kelsey, New York Presbyterian Hospital, Stillwater, PA, United States; Mudit Gupta, Geisinger Health System, Rockville, MD, United States; Paul J. Bellino, Pediatric Residency Program - Geisinger, Danville, PA, United States

Presenting Author(s)

Rebecca Callahan, DO (she/her/hers)

Pediatric Hospital Medicine Fellow PGY5
Baylor College of Medicine
San Antonio, Texas, United States

Background: Despite known physical red flags and social risk factors, missed cases of child physical abuse (CPA) continue. No prior studies have evaluated missed medical appointments as a risk factor for CPA.

Objective:

The objective was to determine if an association exists between missed appointments and admission for CPA.

Design/Methods:

A 20-year, single health system, retrospective chart review of patients < 36 months of age meeting International Classification of Diseases (ICD) 9/10 criteria for CPA who had > 1 scheduled appointment in our healthcare system prior to their admission. Cases categorized as definite physical abuse, high likelihood of abuse, low likelihood, or no concern for physical abuse/unable to be determined. Cases identified as definite or high likelihood of CPA were matched (5:1) with controls based on age, distance to primary care provider’s (PCP’s) office, and race. Missed appointments were compared between cases (n = 146) and controls (n = 730).

Results:

A significant difference was identified between case and control groups (26% vs 9%, p< 0.001) for median proportion of missed appointments. After adjusting for matched and significant covariates, a 3% increase in a patient’s odds of admission for CPA was found for each 1% increase in missed appointments.

Conclusion(s):

An association exists between missed appointments and future admission for CPA. This new data has potential to be implemented into clinical settings to assist with risk stratification for possible CPA. Limitations include single healthcare system, ICD criteria determined by research team, limited documentation for some patients, and narrow definition of definite CPA.