Transportation Barriers in Pediatric Orthopaedic Clinic Visits.

Objectives: To identify what transportation barriers pediatric patients face when traveling to a major metropolitan orthopaedic center, how these barriers affect care, and what changes can be made to address this issue.

Study Design: A cross-sectional transportation survey was administered to 107 caregivers of patients being seen in the orthopaedic clinic at a tertiary children's hospital in a large metropolitan area. Using logistic regression analysis, we compared socioeconomic characteristics, transportation methods, and scheduling practices among caregivers who reported missing at least one visit in the past and those who reported never missing a visit.

Results: 13% (14/108) of caregivers reported missing one or more past visits due to late arrival or transportation issues. Families that traveled more than 45 minutes to clinic (P = 0.04), waited more than one week to schedule a visit (P = 0.002), or reported difficulty scheduling a visit (P = 0.02) were significantly more likely to have a history of nonattendance. In addition, patients who were nonambulatory (P = 0.007), used a mobility device (P = 0.007), or were non-White (P < 0.05) were significantly more likely to have missed a visit.

Conclusion: Travel time, difficult or delayed scheduling, and patient ambulatory status were all associated with missing orthopaedic clinic visits although other socioeconomic factors were not related. Interventions to improve orthopaedic clinic attendance should focus on promoting accessibility for patients with mobility limitations and encouraging simple and timely scheduling practices.