{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:11:02Z","timestamp":1747195862658,"version":"3.40.5"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Following the 2016 US Presidential election, immigration enforcement became more aggressive, with variation by state and region depending on local policies and sentiment. Increases in enforcement created an environment of risk for decreased use of health care services among especially among Latino families. of Hispanic ethnicity and\/or from Latin American origin (as a group subsequently referred to as Latino). For Latino children with chronic health conditions, avoidance of routine health care can result in significant negative health consequences such as disease progression, avoidable use of acute health care services, and overall increased costs of care. To investigate for changes in visit attendance during the periods before and since increased immigration enforcement, we extracted data on children followed by subspecialty clinics of one healthcare system in the US state of North Carolina during 2015\u20132019. For each patient, we calculated the proportion of cancelled visits and no-show visits out of all scheduled visits during the 2016\u20132019 follow-up period. We compared patient characteristics (at the 2015 baseline) according to whether they cancelled or did not show to any visits in subsequent years by clinic and patient factors, including ethnicity. Data were analyzed using multinomial logistic regression of attendance at each visit, including an interaction between visit year and patient ethnicity. Among 852 children 1 to 17 years of age (111 of Latino ethnicity), visit no-show was more common among Latino patients, compared to non-Latino White patients; while visit cancellation was more common among non-Latino White patients, compared to Latino patients. There was no significant interaction between ethnicity and trends in visit no-show or cancellation. Although differences in pediatric specialty clinic visit attendance by patient ethnicity were seen at study baseline, changing immigration policy and negative rhetoric did not appear to impact use of pediatric subspecialty care.<\/jats:p>","DOI":"10.1371\/journal.pgph.0001816","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T17:25:40Z","timestamp":1681406740000},"page":"e0001816","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ethnicity and trends in pediatric specialty care clinic attendance at an academic medical center in the rural southeastern US"],"prefix":"10.1371","volume":"3","author":[{"given":"Philip","family":"Maness","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dmitry","family":"Tumin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rushina","family":"Cholera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David N.","family":"Collier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8000-7285","authenticated-orcid":true,"given":"Luisa","family":"Bonilla-Hernandez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5578-1356","authenticated-orcid":true,"given":"Suzanne","family":"Lazorick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"volume-title":"America\u2019s Children: Key National Indicators of Well-Being, 2019.","year":"2019","key":"pgph.0001816.ref001"},{"key":"pgph.0001816.ref002","first-page":"1","volume-title":"DAPA Matters","author":"M Pastor","year":"2015"},{"key":"pgph.0001816.ref003","unstructured":"United States, Congress, Civil Rights Division, and Thomas Perez. 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Armus","year":"2019","journal-title":"The Charlotte Observer."},{"issue":"8","key":"pgph.0001816.ref030","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1007\/s00247-017-3851-8","article-title":"Predictors of missed appointments in patients referred for congenital or pediatric cardiac magnetic resonance.","volume":"47","author":"J Lu","year":"2017","journal-title":"Pediatr Radiol."},{"issue":"6","key":"pgph.0001816.ref031","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2019-0545","article-title":"Unscheduled Referrals and Unattended Appointments After Pediatric Subspecialty Referral","volume":"144","author":"J Bohnhoff","year":"2019","journal-title":"Pediatrics"},{"issue":"2","key":"pgph.0001816.ref032","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.jaad.2019.02.018","article-title":"Improving nonattendance rates among pediatric patients with Medicaid or private insurance","volume":"81","author":"S Chaudhry","year":"2019","journal-title":"J Am Acad Dermatol"},{"issue":"6","key":"pgph.0001816.ref033","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1111\/pde.13943","article-title":"Wait times, health care touchpoints, and nonattendance in an academic pediatric dermatology clinic.","volume":"36","author":"M Stephens","year":"2019","journal-title":"Pediatr Dermatol"},{"issue":"6","key":"pgph.0001816.ref034","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.anai.2015.03.011","article-title":"Referral patterns and no-show rates at an outpatient pediatric allergy\/immunology clinic","volume":"114","author":"K. Strothman","year":"2015","journal-title":"Ann Allergy Asthma Immunol"},{"issue":"9","key":"pgph.0001816.ref035","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1177\/0009922811410876","article-title":"Appointment attendance in a pediatric weight management clinic.","volume":"51","author":"E Halvorson","year":"2012","journal-title":"Clin Pediatr (Phila)."},{"issue":"2","key":"pgph.0001816.ref036","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.amjoto.2016.11.004","article-title":"The financial impact of clinic no-show rates in an academic pediatric otolaryngology practice.","volume":"38","author":"Z Huang","year":"2017","journal-title":"Am J Otolaryngol"},{"key":"pgph.0001816.ref037","first-page":"205","article-title":"Social Risk Factors Impact Hospital Readmission and Outpatient Appointment Adherence for Children with Congenital Heart Disease","author":"A Demianczyk","year":"2019","journal-title":"J Pediatr"},{"issue":"4","key":"pgph.0001816.ref038","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1017\/S1047951117002748","article-title":"Prevalence and risk factors associated with non-attendance in neurodevelopmental follow-up clinic among infants with CHD.","volume":"28","author":"E Loccoh","year":"2018","journal-title":"Cardiol Young."},{"issue":"4","key":"pgph.0001816.ref039","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.urpr.2016.07.003","article-title":"Factors Affecting Missed Appointments in a Pediatric Urology Outpatient Clinic.","volume":"4","author":"C Cooper","year":"2017","journal-title":"Urology Practice"},{"issue":"2","key":"pgph.0001816.ref040","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1097\/MPG.0000000000000791","article-title":"Improving Nonattendance at Outpatient Pediatric Endoscopy Unit of a Tertiary Center","volume":"61","author":"D Kogan-Liberman","year":"2015","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"13","key":"pgph.0001816.ref041","first-page":"512","article-title":"Outpatient Follow-up Care After Hospital Discharge of Children With Complex Chronic Conditions at a Rural Tertiary Care Hospital\/ Clin.","volume":"60","author":"A Brown","year":"2021","journal-title":"Ped"},{"issue":"1","key":"pgph.0001816.ref042","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/ruso.12116","article-title":"The New Destination Disadvantage: Disparities in Hispanic Health Insurance Coverage Rates in Metropolitan and Nonmetropolitan New and Established Destinations.","volume":"82","author":"S. Monnat","year":"2017","journal-title":"Rural Sociol."}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0001816","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T17:26:12Z","timestamp":1681406772000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0001816"}},"subtitle":[],"editor":[{"given":"Julia","family":"Robinson","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,4,13]]},"references-count":42,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0001816","relation":{},"ISSN":["2767-3375"],"issn-type":[{"type":"electronic","value":"2767-3375"}],"subject":[],"published":{"date-parts":[[2023,4,13]]}}}