2023 Early Hearing Detection & Intervention Conference
March 5-7, 2023 • Cincinnati, OH
2/27/2017 | 11:35 AM - 12:05 PM | Impact of Hospital Scheduling on Follow-up Appointments After Failed Newborn Hearing Screening | Hanover D
Impact of Hospital Scheduling on Follow-up Appointments After Failed Newborn Hearing Screening
Each year approximately 53,000 infants are screened for hearing loss in Kentucky. Infants who fail newborn hearing screen should be referred for follow-up diagnostic testing. From 2011 to 2015, Kentucky observed an overall lost to follow-up rate of 11.2%. In 2012, to address this non-adherence, the Kentucky Early Hearing Detection and Intervention (EHDI) program began encouraging hospitals to schedule follow-up visits for infants that failed their newborn hearing screen.
We accessed screening and community-level data from the Kentucky EHDI database and the Area Health Resource File, respectively. Hospital appointment scheduling is reported on each case at the time the screening results are reported. Follow-up services are reported by centers providing such services. The hospital and follow-up center data are linked at the individual level and community characteristics such as poverty and rurality were linked using zip codes. The study used a logistic regression model to evaluate the effects of hospital scheduling on follow-up, while controlling for individual, hospital, and community characteristics.
The study included 8,992 individual cases where demographic, screening, and follow-up data were available. We observe a positive association between hospital scheduling of follow-up appointment and documented receipt of follow-up services (OR=1.48, p-value<0.001). Infants of Other race (non-White, non-Black) were more likely to receive follow-up (OR=1.83, p-value<0.001), compared to White infants. Statistically significant factors associated with decreased odds of follow-up included Black race, maternal age of 18-24 years, NICU admission greater than five days, residence in a community with a higher percentage of the population living in poverty, and residence in certain Medicaid regions of the state.
State EHDI programs may consider hospital scheduling initiatives as one strategy for improving loss to follow-up. Other individual and community characteristics are also persistent barriers to follow-up and additional interventions targeting those disparities may also offer improvements system-wide.
- Understand Kentucky approach to implementing hospital scheduling of follow-up appointments and data tracking/management.
- Identify impact of hospital scheduling on receipt of follow-up services at the individual level.
- Identify other key factors that influence receipt of follow-up services.
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Presenters/Authors
Cathy Lester
(), cathy.lester63@gmail.com;
Cathy graduated in 1985 with a BA in Biology. She taught high school biology and math for then moved to Child Welfare at Home of the Innocents for 6 years and then moved to DCBS in CPS Investigations. She worked in investigations, family court, adoptions, and with medically fragile foster children. She joined the EHDI program at the Commission for Children with Special Health Care Needs in September 2011. As the EHDI Health Program Administrator, she works within KY CHILD and CCSHCN’s database to ensure accuracy of data, assist families and providers with information and programming technical assistance. She has her Master’s degree in Social Work and 35 hours post Master’s work. She has also taught Research and Statistics at Kent School of Social Work and Social Work Practice at Spalding School of Social Work.
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Liza Creel
(), University of Louisville School of Public Health and Information Sciences, liza.creel@louisville.edu;
Liza M. Creel is currently an Assistant Professor and Commonwealth Scholar in the Department of Health Management and Systems Sciences at the University of Louisville School of Public Health and Information Sciences. Her research is in the areas of delivery system transformation, maternal and child health, organizational collaboration within the health care system, and policy evaluation (including that related to implementation of the Affordable Care Act). Dr. Creel has worked extensively with the KY Early Hearing Detection and Intervention Program in 2016 under a Memorandum of Understanding outline her role in assisting the Program in data analytics and evaluation. She received her PhD in Health Services Research from the Texas A&M Health Science Center, School of Public Health; MPH in Health Policy from the University of Michigan, School of Public Health; and BS in Health Services Administration from the University of Texas, Southwestern School of Allied Health Sciences.
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Matthew L. Bush, M.D.
(), University of Kentucky Dept. of Otolaryngology, matthew.bush@uky.edu;
Matthew L. Bush, M.D. is an Assistant Professor in the Department of Otolaryngology – Head and Neck Surgery. He earned his M.D. degree at Marshall University in Huntington, WV in 2003. He completed Otolaryngology residency at the University of Kentucky in 2008 followed by a post-doctoral research fellowship and Neurotology & Cranial Base Surgery fellowship at The Ohio State University (2008-2011). Board certified in Otolaryngology and Neurotology, Dr. Bush’s clinical practice focuses on disorders of hearing and balance, including pediatric cochlear implantation. This clinical practice blends well with Dr. Bush’s research interests, which are directed at assessing and addressing rural pediatric and adult hearing health disparities. A K23 Career Development Award from the NIH National Institute of Deafness and Communication Disorders and a Triological Society Career Development Award supports this research. Recent research has been published in The Journal of Pediatrics, Ear & Hearing, The Laryngoscope, and Otology & Neurotology.
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