Neonatology Fellow NewYork-Presbyterian Morgan Stanley Children's Hospital New York, New York, United States
Background: Access to NICU Follow-up programs is essential for high-risk infants, yet non-attendance rates range from 20-80% across the nation. Studies have shown that race and rurality affect follow-up program participation; there is conflicting or lacking evidence about other factors that are most impactful on families’ abilities to attend. At our Level IV NICU, we have consistently observed a 20% no-show rate of scheduled follow-up appointments despite targeted outreach and prior QI efforts. This unique study explores factors associated with non-attendance of a NICU follow-up program serving a diverse population of racial/ethnic, religious, and socioeconomic backgrounds in an urban setting. Objective: To identify clinical and sociodemographic factors associated with NICU follow-up clinic non-attendance compared to successful attendance to inform future qualitative assessments of parent perceptions and equity-focused QI efforts. Design/Methods: After IRB approval, we identified all infants scheduled for NICU follow-up appointments between Jan 1, 2021-Dec 31, 2022. We excluded infants who moved out of the local catchment area or who died post-NICU discharge prior to their scheduled appointment. Patients are divided into 3 groups: (1) “no-showed” or cancelled/never rescheduled their first appointment, (2) attended first appointment but no subsequent visits and (3) successfully attended 3 or more appointments. We are collecting clinical and sociodemographic characteristics for each infant; for inborn infants, maternal information is also collected. We will assess neighborhood childhood opportunity index (COI), distance from clinic, mode of visit, insurance type, race/ethnicity, preferred language, maternal age, marital and employment status, and household size. Statistical analysis includes bivariate analysis of all collected factors and the primary outcome of clinic non-attendance. We will use multivariable logistic regression to determine independent factors associated with non-attendance of any appointment, non-attendance after first visit and successful attendance.
