Pediatric Obesity In Primary Care: Examining Patient Access Across Service Delivery Models | Insight Medical Publishing

Background: Appointment failure is a major barrier to the delivery of pediatric weight management treatment. The purpose of this pilot study was to compare appointment follow-through data and associated variables (appointment wait time and distance to travel to clinic) across two weight management service delivery models within the same health system. Changes in weight and BMI z-score were also calculated and compared across each setting. Method: A quasi-experimental, matched comparison design was used to compare appointment follow-through, initial appointment wait time, distance to travel to clinic, and changes in weight and BMI z-score across the two treatment settings. Demographic, anthropometric, and appointment data were collected over a six-month interval. Data were obtained through retrospective chart review using the institutional electronic health record (EHR) scheduling report function through Epic Systems software (Epic, Verona, WI). Results: Participants (N=30), ages 5 through 18 were scheduled in two pediatric weight management clinics. Independent sample t-tests were performed to examine mean differences in appointment follow-through, wait-time, and distance travelled across each clinic (n=15). Significantly fewer appointment failures (no shows and cancellations combined) were documented within the primary care setting. Additionally, patients waited significantly less time for their initial appointment and travelled a significantly shorter distance to clinic. No significant differences were found in appointment completion and weight metrics across the two clinics. Conclusion: Limitations of this study include a small sample size and lack of randomization between groups. Further research is needed to measure the impact of integrated models of care on pediatric obesity treatment.