Abstract：
Little data exists on the association of missed care opportunities (MCOs) in children referred for nuclear medicine/nuclear oncology imaging examinations and socioeconomic disparities.
To determine the prevalence of MCOs in children with lymphoma/leukemia scheduled for fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and the impact of sociodemographic factors and Child Opportunity Index (COI).
Retrospective analysis of MCOs in children with lymphoma/leukemia scheduled for FDG-PET/CT (2012 to 2022) was performed. In univariate analysis, patient, neighborhood, and appointment data were assessed across MCOs and completed appointments. Logistic regression evaluated independent effects of patient-, neighborhood-, and appointment-level factors with MCOs. Two-sided P-value < .05 was considered statistically significant.
In 643 FDG-PET/CT appointments (n = 293 patients; median age 15 years (IQR 11.0-17.0 years); 37.9% female), there were 20 MCOs (3.1%) involving 16 patients. Only 8.2% appointments involved Black/African American non-Hispanic/Latino patients, yet they made up a quarter of total MCOs. Patients living in neighborhoods with very low or low COI experienced significantly higher MCOs versus zip codes with very high COI (6.9% vs. 0.8%; P = 0.02). Logistic regression revealed significantly increased likelihood of MCOs for patients aged 18 to 21 [odds ratio (OR) 4.50; 95% CI 1.53-13.27; P = 0.007], Black/African American non-Hispanic/Latino (OR 3.20; 95% CI 1.08-9.49; P = 0.04), zip codes with very low or low COI (OR 9.60; 95% CI 1.24-74.30; P = 0.03), and unknown insurance status.
Children with lymphoma/leukemia, living in zip codes with very low or low COI, and who identified as Black/African American non-Hispanic/Latino experienced more MCOs. Our study supports the need to address intersecting sociodemographic, neighborhood, and health system factors that will improve equitable access to necessary healthcare imaging for children.
To determine the prevalence of MCOs in children with lymphoma/leukemia scheduled for fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and the impact of sociodemographic factors and Child Opportunity Index (COI).
Retrospective analysis of MCOs in children with lymphoma/leukemia scheduled for FDG-PET/CT (2012 to 2022) was performed. In univariate analysis, patient, neighborhood, and appointment data were assessed across MCOs and completed appointments. Logistic regression evaluated independent effects of patient-, neighborhood-, and appointment-level factors with MCOs. Two-sided P-value < .05 was considered statistically significant.
In 643 FDG-PET/CT appointments (n = 293 patients; median age 15 years (IQR 11.0-17.0 years); 37.9% female), there were 20 MCOs (3.1%) involving 16 patients. Only 8.2% appointments involved Black/African American non-Hispanic/Latino patients, yet they made up a quarter of total MCOs. Patients living in neighborhoods with very low or low COI experienced significantly higher MCOs versus zip codes with very high COI (6.9% vs. 0.8%; P = 0.02). Logistic regression revealed significantly increased likelihood of MCOs for patients aged 18 to 21 [odds ratio (OR) 4.50; 95% CI 1.53-13.27; P = 0.007], Black/African American non-Hispanic/Latino (OR 3.20; 95% CI 1.08-9.49; P = 0.04), zip codes with very low or low COI (OR 9.60; 95% CI 1.24-74.30; P = 0.03), and unknown insurance status.
Children with lymphoma/leukemia, living in zip codes with very low or low COI, and who identified as Black/African American non-Hispanic/Latino experienced more MCOs. Our study supports the need to address intersecting sociodemographic, neighborhood, and health system factors that will improve equitable access to necessary healthcare imaging for children.
摘要：
背景：关于接受核医学/核肿瘤学影像学检查的儿童的错失护理机会（MCO）与社会经济差异的关联的数据很少。
目的：确定计划使用氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）的淋巴瘤/白血病儿童中MCO的患病率以及社会人口统计学因素和儿童机会指数（COI）的影响。
方法：回顾性分析计划进行FDG-PET/CT（2012年至2022年）的淋巴瘤/白血病儿童的MCO。在单变量分析中，病人,邻居,和预约数据在MCO和完成的预约中进行评估.Logistic回归评估患者的独立效应-，邻居-,以及MCO的任命级别因素。双侧P值<0.05被认为具有统计学意义。
结果：在643个FDG-PET/CT预约中（n=293例；中位年龄15岁（IQR11.0-17.0岁）；37.9%女性），有20例MCO(3.1%),涉及16例患者.只有8.2％的任命涉及黑人/非洲裔非西班牙裔/拉丁裔患者，然而，它们占MCO总数的四分之一。生活在COI非常低或低的社区中的患者的MCOs明显高于COI非常高的邮政编码（6.9％vs.0.8%；P=0.02）。Logistic回归显示18~21岁患者发生MCO的可能性显著增加[比值比(OR)4.50;95%CI1.53~13.27;P=0.007],黑人/非洲裔非西班牙裔/拉丁美洲人（OR3.20；95％CI1.08-9.49；P=0.04），具有非常低或低COI的邮政编码（OR9.60；95％CI1.24-74.30；P=0.03），未知的保险状况。
结论：儿童淋巴瘤/白血病，生活在非常低或低COI的邮政编码中，被认定为黑人/非洲裔非西班牙裔/拉丁裔的人经历了更多的MCO。我们的研究支持解决交叉社会人口统计学问题的必要性，邻居,和卫生系统因素，这些因素将改善儿童获得必要的医疗保健成像的公平机会。
目的：确定计划使用氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）的淋巴瘤/白血病儿童中MCO的患病率以及社会人口统计学因素和儿童机会指数（COI）的影响。
方法：回顾性分析计划进行FDG-PET/CT（2012年至2022年）的淋巴瘤/白血病儿童的MCO。在单变量分析中，病人,邻居,和预约数据在MCO和完成的预约中进行评估.Logistic回归评估患者的独立效应-，邻居-,以及MCO的任命级别因素。双侧P值<0.05被认为具有统计学意义。
结果：在643个FDG-PET/CT预约中（n=293例；中位年龄15岁（IQR11.0-17.0岁）；37.9%女性），有20例MCO(3.1%),涉及16例患者.只有8.2％的任命涉及黑人/非洲裔非西班牙裔/拉丁裔患者，然而，它们占MCO总数的四分之一。生活在COI非常低或低的社区中的患者的MCOs明显高于COI非常高的邮政编码（6.9％vs.0.8%；P=0.02）。Logistic回归显示18~21岁患者发生MCO的可能性显著增加[比值比(OR)4.50;95%CI1.53~13.27;P=0.007],黑人/非洲裔非西班牙裔/拉丁美洲人（OR3.20；95％CI1.08-9.49；P=0.04），具有非常低或低COI的邮政编码（OR9.60；95％CI1.24-74.30；P=0.03），未知的保险状况。
结论：儿童淋巴瘤/白血病，生活在非常低或低COI的邮政编码中，被认定为黑人/非洲裔非西班牙裔/拉丁裔的人经历了更多的MCO。我们的研究支持解决交叉社会人口统计学问题的必要性，邻居,和卫生系统因素，这些因素将改善儿童获得必要的医疗保健成像的公平机会。
