Objective
   To understand why pediatric otolaryngology patients do not attend scheduled clinic appointments and identify factors correlated with no-show status.
         Study Design
   Retrospective cohort study.
         Methods
   This is a retrospective cohort study that uses medical record data extraction of patients that was scheduled to attend new patient appointments at a pediatric otolaryngology clinic in 2018.
         Results
   Factors associated with no-shows included complex psychiatric history (OR (95% CI) 0.789 (0.71–0.88), P < .001), increased appointment lead time (OR (95% CI) 0.981 (0.976–0.987), P < .001), afternoon appointments (OR (95% CI) 0.783 (0.64–0.99), P = .038), and complex maternal medical history (OR (95% CI) 0.987 (0.979–0.996), P < .005). In contrast, factors associated with attendance included complex patients' medical history (OR (95% CI) 1.058 (0.98–1.02), P < .001), primary care physician at the same hospital (OR (95% CI) 2.766 (2.25–3.39), P < .001), and primary language being Spanish (OR (95% CI) 2.536 (1.75–3.67) P < .001). The factors of distance from the hospital (OR (95% CI) 1.001 (0.99–1.01), P = .868), season of appointment (P = .997), race (P = .623), and ethnicity (P = .804) were not as   sociated with attendance or no-shows.
         Conclusion
   Patient and maternal medical problems, mental health history, primary care location, appointment lead time, hour of appointment, and primary language, all contribute to appointment attendance, while appointment timing, race, and ethnicity are not associated with attendance. Further work must be performed to overcome these barriers to minimize healthcare risks and improve patient outcomes.
         Quality of Evidence
   Level 3 Laryngoscope, 2021
  					  					
    			                                                                                                         
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