Factors affecting clinic attendance for children referred with middle ear conditions

Abstract

Background: Middle ear disease is common in children and, if untreated, can lead to long term complications. This study investigated whether ethnic or socioeconomic inequities existed among children referred to a tertiary regional paediatric ORL service. Methods: All middle ear pathology related referrals to Starship Children's Hospital ORL service during 2018 and 2019 were reviewed. Online clinical records were accessed to collect demographic data and appointment outcomes. The relationships between ethnicity, socioeconomic status, age at referral and clinic attendance were analysed. Results: A total of 1530 children were referred and 214 (14.0%) of these did not attend their scheduled appointments. Compared with the age of referral for European children, Māori children were referred on average 1.1 years older while Pasifika children were referred 2.4 years older. Compared to European children, Māori children were 4.3 times more likely to miss an appointment while Pasifika were 7.2 times more likely. Socioeconomic status had no significant effect on either age of referral or clinic attendance. Conclusions: Māori and Pasifika children with middle ear disease are referred later and are more likely to miss outpatient clinic appointments. Pasifika children are affected more than Māori.