Original ArticleCare Utilization in a Pediatric Diabetes Clinic: Cancellations, Parental Attendance, and Mental Health Appointments
Section snippets
Methods
The Joslin Diabetes Center is located in Boston in an urban setting. Approximately 95% of the clinic's pediatric patients reside in Massachusetts or in neighboring New England states. These patients reflect the ethnic mixture of New England and represent all socioeconomic strata.
Our multidisciplinary pediatric diabetes team recommends visits according to American Diabetes Association (ADA) guidelines (roughly every 3-4 months) with a medical provider (MD, nurse practitioner [NP], or registered
Results
The 1771 individual patients (51% female) eligible for inclusion in this study had a total of 17 984 scheduled appointments during the 2-year observation period. The mean patient age at the time of the first visit during this 2-year period was 15 ± 5.2 years. The age distribution was 3% young children (0-5 years), 31% school-aged children (6-12 years), 32% adolescents (13-17 years), and 35% young adults (18-29 years). The mean duration of diabetes was 8.5 ± 5.1 years. At the first visit during
Discussion
Over a 2-year observation period, 15% of scheduled visits at an outpatient pediatric diabetes clinic yielded a cancellation or no-show, with an average of 1.6 ± 2.1 missed visits per patient. Sixty-one percent of patients missed at least 1 visit over the 2-year period, although the majority (60%) completed ≥6 visits over the 2-year period, consistent with ADA recommendations for visits every 3-4 months.31 Missed visit rates were higher for mental health providers and dieticians and lower for
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Funded by the National Institute of Diabetes and Digestive and Kidney Diseases (K23DK092335 and P30DK036836), the Eleanor Chesterman Beatson Fund, the Katherine Adler Astrove Youth Education Fund, and the Maria Griffin Drury Pediatric Fund. The authors declare no conflicts of interest.