Abstract
Objective
To identify sociodemographic and clinical factors associated with missed outpatient plastic surgery appointments among children with cleft lip and palate (CLP).
Design
Retrospective chart review.
Setting
Single urban academic tertiary pediatric hospital.
Patients/Participants
Children with CLP who underwent cleft lip repair between 2015 and 2025. Exclusion criteria included <5 total outpatient visits during the study period or out-of-state primary residence.
Interventions
Not applicable (observational). Management included routine surgical follow-up.
Main Outcome Measure(s)
Occurrence of ≥1 missed outpatient appointment No-show rate (%) among patients with any missed visit.
Results
The cohort (n = 308) was predominantly Hispanic/Latino (55.2%), with high prevalence of public insurance (61.0%), siblings (71.4%), and household instability (40.6%). Patients attended a mean of 12.0 appointments over 5.2 years of follow-up, with 46.1% missing at least one visit. Among those with ≥1 missed appointment, the mean no-show rate was 8.4%. Hierarchical logistic regression identified Black race, household instability, siblings, and pulmonology care as being associated with appointment no-show. In hierarchical linear regression among patients with ≥1 missed visit, older age at follow-up and greater surgical burden were associated with slightly lower no-show rates, with limited contribution from sociodemographic or care coordination factors.
Conclusions
Disparities in appointment attendance may be driven by household-level and clinical complexity factors. Interventions supporting families facing household instability and high caregiving demands may help reduce missed outpatient plastic surgery visits.
Get full access to this article
View all access options for this article.