Sociodemographic Factors Associated With Adherence to Referrals From the Pediatric Emergency Department

Outpatient referrals constitute a critical component of emergency medical care. However, barriers to care after emergency department (ED) visits have not been investigated thoroughly. The purpose of this study was to determine the impact of sociodemographic variables on referral attendance after ED...

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Bibliographic Details
Published in:The Journal of emergency medicine 2020-04, Vol.58 (4), p.594-602
Main Authors: Palleiko, Benjamin A., Lynn, Jeremy V., Achkar, Angie H., Hart-Johnson, Tamera, Perry, Marcia A., Blackwood, R. Alexander
Format: Article
Language:English
Subjects:
Aged
Ambulatory Care Facilities
Child
emergency department
Emergency Service, Hospital
Female
health disparities
Hospitals, Pediatric
Humans
pediatrics
Referral and Consultation
referrals
Retrospective Studies
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Summary:Outpatient referrals constitute a critical component of emergency medical care. However, barriers to care after emergency department (ED) visits have not been investigated thoroughly. The purpose of this study was to determine the impact of sociodemographic variables on referral attendance after ED visits. A retrospective cohort study was designed. Patients aged 0–17 years who visited the C.S. Mott Children's Hospital ED in 2016 and received a referral were included. Multiple referrals for 1 patient were counted as independent encounters for statistical analysis. Chart review was performed on 6120 pediatric ED encounters, producing a total of 822 referrals to University of Michigan Health System outpatient clinics. Referral attendance did not differ by race, ethnicity, language, or religion. Older age was associated with decreased attendance at referrals (p = 0.043). Patients who were black and female (p = 0.019), patients with public health insurance (p = 0.004), and patients residing in areas with either high rates of unemployment (p = 0.003), or lower high school education rates (p = 0.006) demonstrated decreased attendance. Patients referred to pediatric neurology had lower attendance rates (p 
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2019.11.023