Abstract 4137053: Association of Childhood Opportunity Index and No Show Rates in a Pediatric Cardiology Clinic.

Introduction: Childhood Opportunity Index (COI) measures access to quality education, safe housing, and healthcare based on zip codes. These scores can influence patient behaviors, such as no-shows (NS), which can affect resource utilization and health outcomes. Objective: To quantify the correlation between COI and NS through odds ratio (OR) in a pediatric cardiology clinic. Methods: Patient data was collected from a single, independent pediatric cardiology practice for all visits between 2019 to 2021. COI was categorized into 3 subdomains; education, health and environment, social and economic according to zipcode from Diversitydatakids. The COI was split into low (<40), moderate (40-60U), and high (>60U). Additional variables included age, insurance type, lead time (time from scheduling to appointment date), and telehealth status. Multiple logistic mixed-effect models, both unadjusted (single predictor) and adjusted (multiple predictors), were used to obtain OR for NS. Results: There were 11,474 total encounters. 92% were completed appointments and 8% were NS. Unadjusted model showed statistical significance (p<.05) with increased odds of NS for low COI education, low COI social and economic, and low COI, compared to high COI as the reference category (Table 1). Adjusted model 2 showed similar significant results for the low COI overall category, while for adjusted models 1 and 3, none of the COI categories were statistically significant. In all 4 models, OR for all age categories, all lead times, and public and mixed insurance types were significant. Conclusion: The unadjusted and adjusted model 2 showed that patients with lower COIs were more likely to NS. Public insurance and longer lead times were indicators of NS while higher ages were indicators for completed appointments. Therefore, efforts need to be made to identify vulnerable patients; younger patients, and those with lower COIs and public insurance; and address barriers such as arranging transport and sending reminders that can help decrease NS. Interestingly, the NS rate was lower than the national average. Future research is needed to assess the impact of NS on patient outcomes.