0924 Pathways to Care: Assessing the Impact of Referral Sources on Longitudinal Wait Times

Abstract Introduction Excessive wait times regarding pediatric sleep disorders is an issue without borders. Within the United States, wait times can be exacerbated due to issues such as insurance coverage, socioeconomic status, and the limited number of pediatric sleep medicine specialist and technologists. Implications of delays in OSA diagnosis and treatment are well documented. To mitigate these impacts and streamline wait times, a direct to sleep lab referral process for providers who were trained to identify sleep related breathing disorders (SRBD) by our department was created. This study analyzes diagnostic longitudinal wait times (LWT), as defined by the initial identification of SRBD symptoms to the interpretation of the patient’s PSG, between different referring providers. Methods In this retrospective chart review, an electronic medical record (EMR) query for all patients who completed a pediatric outpatient in-lab polysomnography from 1/1/2025 through 6/30/2025 was performed. Patients without wait time data as well as ordering provider categories with under 5 PSGs were excluded from the dataset. The query yielded a convenience sample of 620 subjects. Results Four ordering provider categories were identified. A one-way ANOVA determined there was a statistically significant difference between group means (F (3,616)=28.46, p< 0.001. The average LWT was significantly lower for the PCP category as compared to the other three groups (PCP = 86 days, ENT = 180 days, Pulmonary = 181 days, and Sleep = 190 days). Conclusion This study demonstrates that patient pathways to care can have a drastic impact on wait times. While PSG order volumes tend to originate from specialty care, it is the PCP pathway that offers patients the most direct route to diagnosis. Through close collaboration PCPs can be empowered to step into a sleep-forward role, thereby reducing wait times and expediting care. While further study is required to evaluate other aspects of care delays, such as time to treatment, the results suggest training front-line resources is a viable way to expedite care for children. Support (if any) None