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Follow-up Appointment Adherence after Pediatric Traumatic Brain Injury

Abstract Details

2018, Doctor of Philosophy, Ohio State University, Public Health.
Traumatic brain injury (TBI) is the leading cause of death and disabilities among children in the United States. Literature indicates that one out of three children with TBI does not receive needed rehabilitation services. Follow-up visits are critical in identifying and addressing the child’s need for rehabilitation services. Without follow-up visits, many TBI-related problems may go undetected and untreated, resulting in delayed childhood development. Despite the importance of follow-up visits after pediatric TBI, no study has examined follow-up appointment adherence in children with TBI. The overarching goal of my study is to examine follow-up appointment adherence after pediatric TBI. My specific aims are: 1) To assess the extent to which children with TBI do not attend follow-up appointments and identify risk factors for failure to follow-up; 2) To identify caregiver-perceived barriers and facilitators to return for follow-up; and 3) To evaluate the impact of failure to follow-up on patient outcomes. Using data from trauma registry, electronic health record, and survey questionnaire, I found that 45.7% of children with TBI missed at least one appointment within 1 year after discharge. Children from socially disadvantaged families and those with appointments at more than one department were more likely to miss appointments. The top three reported barriers were “no need”, “schedule conflicts” and “lack of resources.” The top three reported facilitators were “good hospital experience”, “need” and “sufficient resources.” Those with poor follow-up adherence may have worse quality-of-life outcomes. To improve TBI follow-up adherence, providers may better communicate with caregivers to make sure they understand the long-term effects of TBI and the consequences of missing follow-up appointments. Hospitals may assign care coordinators to help caregivers navigate their child’s care from hospital arrival to follow-up after discharge. Care coordinators may identify families in need, and connect them to agencies that provide enabling resources such as health insurance and transportation. In addition, having all follow-up appointments within one center may help improve follow-up adherence. A large multi-center study is warranted to confirm and extend my findings.
Henry Xiang (Advisor)
107 p.

Recommended Citations

Citations

  • Peng, J. (2018). Follow-up Appointment Adherence after Pediatric Traumatic Brain Injury [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1520418824950075

    APA Style (7th edition)

  • Peng, Jin. Follow-up Appointment Adherence after Pediatric Traumatic Brain Injury. 2018. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1520418824950075.

    MLA Style (8th edition)

  • Peng, Jin. "Follow-up Appointment Adherence after Pediatric Traumatic Brain Injury." Doctoral dissertation, Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1520418824950075

    Chicago Manual of Style (17th edition)