167 - Appointment Time Does Not Impact Adolescent Depression Screening Rates Across a Large New York Health System

Poster Number: 167
Publication Number: 167.316

Kelly A. Cann, Cohen Children's Medical Center, Manhasset, NY, United States; Caren Steinway, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, United States; Jack Chen, Northwell Health, Jamaica, NY, United States; Sophia Jan, Cohen Children's Medical Center, New Hyde Park, NY, United States

Background: Completion of preventative healthcare measures, such as administering screenings and immunizations, are impacted by patient, provider, and environmental factors. Adult influenza vaccination is associated with earlier appointment times and provider experience. The impact of appointment time on routine adolescent depression screening rates is unknown.

Objective: To identify the impact of appointment time, and other patient and physician characteristics, on depression screening during adolescent preventive care visits across a regional pediatric primary care network associated with a children’s hospital.

Design/Methods: We conducted a retrospective cohort study of a random selection of preventive care encounters of patients 11 to 21 years old seen across 22 pediatric primary care practices from January 2020 to August 2021. Primary outcome was depression screening, as defined by documentation of PHQ2 or PHQ9 at the time of the visit. Primary predictor was appointment time. Additional covariates included appointment day of the week and other patient and provider characteristics. We conducted descriptive statistics. We used logistic regression to determine the impact of appointment time on depression screening.

Results: Our cohort consisted of 621 patients with a mean age of 14.6 years (11-21 years), 53% female, 42% white race, 96.9% with a preferred language of English, and 55.7% with commercial insurance. The bivariate analysis of appointment time compared to depression screening rates was higher from 12-1pm (OR 0.33, CI 0.13- 0.94), but after adjustment for environmental, patient, and provider characteristics, this was no longer statistically significant. Non- white race (African American OR 0.46, CI 0.27- 0.79. Asian Pacific Islander OR 0.49, CI 0.26- 0.93) and female gender (OR 1.64, CI 1.09- 2.46) were the primary patient characteristics driving depression screening rates. The primary provider characteristics driving screening rates included PA or NP degree (OR 3.31, CI 1.18 - 9.33) and having greater than 10 years of experience (OR 4.4, CI 1.55 - 12.59).Conclusion(s): Although we had expected to see some variations in screening rates by appointment time, they were not statistically significant. Screening rates were primarily driven by patient gender, patient race, provider experience, and provider type. Despite controlling for environmental factors, non-white patients are half as likely to be screened for depression.
CV for Kelly A Cann MDCV for Kelly Anne Cann, MD.pdf