Socioeconomic Distress as a Predictor of Missed First Outpatient Newborn Visits

Objective To determine if the Area Deprivation Index (ADI) can serve as a predictor for patients from geographic regions of high socioeconomic distress as high risk for having no-shows to first-year newborn visits. Methods We assessed the no-show rate per patient from a large public safety-net hospital in Cleveland, Ohio, and the ADI of the census-designated tract for each patient's home geographic identifier (GEOID), aggregated into quintiles, and calculated differences in no-show-rates across census-designated tracts of different ADIs. Results A total of 2944 newborns from an approximate 18-month follow-up period between 2015-2017 were included. Large differences in no-shows per individual patient record (chi-square = 225, p = <0.001, df = 4) were found across quintiles of ADI. Heat-mapping indicated that census tracts with the highest ADIs and highest rates of no-show appointments encompass Cleveland's inner-city region. Conclusion The ADI is demonstrated to identify communities at high risk of no-show newborn appointments. Mapping these communities and their socioeconomic distress levels represented by ADI and missed appointment rate for each community can provide future direction for interventions targeted towards these communities to reduce no-show rates and improve overall community infant health.