Key factors that lead to missed outpatient ultrasound appointments
Being part of a marginalized racial or ethnic group, along with insurance status, are significantly associated with missing outpatient imaging appointments, according to new research published in JACR.
Timely delivery of healthcare services is crucial in radiology, with missed appointments leading to delayed diagnoses, decreased access points, lost revenue and increased costs. Boston Children’s Hospital researchers sought to better understand such “imaging missed care opportunities,” homing in on neonatal ultrasound appointments at the urban institution.
Such misses were found to be more likely among patients on Medicaid, Black infants and those residing in a Boston neighborhood with higher rates of poverty and unemployment.
“There is an urgent need to create interventions aimed at reducing [imaging missed care opportunities] to control healthcare costs, improve quality of care, and reduce inequities within radiology in particular and healthcare in general,” Valerie Ward, MD, chief equity and inclusion officer at Boston Children’s, among other titles, and co-authors wrote Jan. 12. “It is important that these recommendations for interventions be patient centered in their implementation, in order to make certain to improve healthcare quality overall and avoid worsening disparities.”
For the study, researchers retrospectively reviewed data from patients 28 days old or younger who had outpatient appointments for head, hip, renal or spine ultrasound. The analysis covered 2008 to 2018 and exams were scheduled at both the main hospital campus and any satellite sites. Imaging missed care opportunities were defined as any cancellation or no-show that occurred less than 24 hours before the appointed time.
More than 6,800 ultrasound appointments met the criteria, across nearly 5,500 patients. Overall, misses occurred at a 4.4% clip and were more likely among Black (odds ratio 3.31) and other-race newborns (2.66), along with those on public insurance (1.78). Imaging missed care opportunities were also more likely for appointments occurring at the main campus compared to satellite sites, along with those occurring during work hours and on weekends.
Ward et al. see myriad opportunities to address these factors in imaging departments across the U.S. The authors urged leaders to seek both operational, such as patient-centered scheduling systems and appointment reminders, along with structural interventions—improving cultural humility and increasing minority representation in the specialty’s workforce.
“It is of the utmost importance that these interventions be accessible to all patients and families regardless of background,” the authors urged. “Future research is needed to explore interventions to reduce IMCOs in neonatal ultrasound specifically and in radiology more broadly in order to achieve health equity in the provision of radiology care,” they added later.
Read more in the Journal of the American College of Radiology’s special January issued dedicated to health equity here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.