The challenges to ophthalmologic follow-up care in at-risk pediatric populations

• Published in: Journal of AAPOS Vol. 17; no. 2; pp. 140 - 143
• Main Authors: Williams, Summer, MD, Wajda, Brynn N., MD, Alvi, Rizwan, MD, McCauley, Colleen, Martinez-Helfman, Sarah, Levin, Alex V., MD, MHSc
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.04.2013
• Subjects: Adolescent; Appointments and Schedules; Child; Child, Preschool; Continuity of Patient Care; Female; Health Services Accessibility; Humans; Male; Ophthalmology; Patient Acceptance of Health Care; Socioeconomic Factors; Surveys and Questionnaires; United States; Urban Population; United States
• ISSN: 1091-8531; 1528-3933
• DOI: 10.1016/j.jaapos.2012.11.021

Purpose To identify barriers to ophthalmological follow-up in high-risk children who are identified by vision screening and eye examination. Methods The records of patients identified as needing follow-up through two free eye care programs (organized optometric and ophthalmologic screening sessions aimed at identifying and treating ocular pathology) targeted toward inner-city youths of low socioeconomic status were reviewed. Parents were contacted by phone, and a questionnaire on barriers to follow-up was administered. Callers attempted to schedule appointments at that time. Data were assessed by means of descriptive analysis. Results Of 93 patients, 54 (58%), were successfully contacted. Of these, 23 (25%) were eventually scheduled. Five (5%) patients elected follow-up elsewhere. Twenty (22%) with working phones were still unable to be scheduled. Additional obstacles included families' lack of awareness of the need for follow-up (13%), assumption by families that they would be contacted (5%), scheduling conflicts (4%), concerns about insurance, and difficulty finalizing referrals (2%). A total of 39 patients (42%) were not successfully contacted because of inoperable phone services, and none of the families responded to the mailed questionnaire. Conclusions Inability to contact families was the greatest barrier to follow-up. Our findings suggest that immediate arrangement of follow-up care, on-site visual assessment, and a program director may be useful in increasing follow-up for high-risk children.