Who is missing? Health-related social risk factors in a paediatric complex respiratory and respiratory infection outpatient clinic

Strong links between lung disease, deprivation and health inequalities are well accepted and of particular concern in Scotland. How to adjust health care interventions to improve outcomes is poorly understood. <bold>Objectives:</bold> Explore whether children and young people (CYP) experiencing deprivation and poor respiratory health are being overlooked for specialist respiratory asessessment and treatment, and whether they participate in specialist respiratory care. <bold>Method:</bold> Retrospective analysis of paediatric respiratory clinic caseload, NHS Lothian, 01/22- 10/23 using the Scottish Index for Multiple Morbidity (SIMD), n= 876. Using postcode analysis, SIMD 1 is listed as being 20% most deprived areas in Scotland and SIMD 5 being least deprived. Participation was measured by attendance at appointments. <bold>Results:</bold> 396/876 were new patient (NP) referrals; 14.5% NP from SIMD 1 and 14% review caseload from SIMD 1. <fig><object-id>erj;64/suppl_68/PA4072/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>CYP were not brought (WNB) to 294 appointments; SIMD 1, 17% and SIMD 5, 26%. Compared to population data there were proportionally more referrals and review appointments for CYP from the most deprived areas, and as a proportion WNB rates were higher in CYP from the lowest quintiles. <bold>Conclusion:</bold> CYP experiencing deprivation have greater respiratory health burden and may still be underreferred. Analysing referral and attendance patterns can help improve equity and identifies risk.