Association of Parent Preventive Care with their Child's Recommended Well-Child Visits |
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| Institution: | 1. Oregon Health & Science University (H Angier, J Kaufmann, J Heintzman, L Moreno, and M Marino), Portland, Ore;2. OCHIN, Inc. (J Heintzman, J O''Malley, and S Giebultowicz), Portland, Ore;1. Department of Pediatrics, Children''s Hospital of Philadelphia (J Schuchard and CB Forrest), Philadelphia, Pa;2. Department of Pediatrics, Cincinnati Children''s Hospital Medical Center, University of Cincinnati College of Medicine (AC Carle), Cincinnati, Ohio;3. Department of Pediatrics, University of Cincinnati College of Arts and Sciences (AC Carle), Cincinnati, Ohio;4. Department of Psychology, University of Cincinnati College of Arts and Sciences (AC Carle), Cincinnati, Ohio;5. Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine (MD Kappelman), Chapel Hill, NC;6. Department of Health and Rehabilitation Sciences, Temple University College of Public Health (CA Tucker), Philadelphia, Pa;1. Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah (EM Keating, M Holsti, and JA Robison), Salt Lake City, Utah;2. Intermountain Primary Children''s Hospital (NJ Tedford, EM Keating, M Holsti, and JA Robison), Salt Lake City, Utah;3. Division of Epidemiology, Department of Internal Medicine, University of Utah (Z Ou), Salt Lake City, Utah;4. University of Utah, College of Nursing (AS Wallace), Salt Lake City, Utah;5. Department of Population Sciences, University of Utah (AS Wallace), Salt Lake City, Utah;1. Department of Pediatrics, Division of Pediatric Emergency Medicine (NJ Tedford), University of Utah, Salt Lake City, Utah;2. Pediatric Emergency Department (NJ Tedford), Intermountain Primary Children’ Hospital, Salt Lake City, Utah;1. Division of Hospital Medicine, Department of Pediatrics (AG Yu, L Agharokh and BC Lee), University of Texas Southwestern Medical Center and Children''s Health, Dallas, Tex;2. Children''s Hospital Association (M Hall and I Zaniletti), Lenexa, Kans;3. Department of Pediatrics (KM Wilson), University of Rochester Medical Center, Rochester, NY;4. Division of Hospital Medicine, Department of Pediatrics (DJ Williams), Vanderbilt University School of Medicine and the Monroe Carell Jr. Children''s Hospital at Vanderbilt, Nashville, Tenn;1. Department of Pediatrics (AR Schroeder), Stanford University School of Medicine, Stanford, Calif;2. Department of Pediatrics (LG Solan), Golisano Children''s Hospital at the University of Rochester Medical Center, Rochester, NY;3. Department of Pediatrics (D Williams), Vanderbilt University School of Medicine and the Monroe Carell Junior Children''s Hospital at Vanderbilt, Nashville, TN;4. Pediatric Academic Societies, Inc. (B Thomas, C Smith, and G Minshew);5. Department of Pediatrics (DA Rauch), Tufts University Medical School, Boston, Mass;1. Division of Pediatric Infectious Diseases, Department of Pediatrics, UCLA Mattel Children''s Hospital, University of California at Los Angeles (AdS Maurice);2. Departments of Political Science and African American Studies, Penn State University (R Block), University Park, Pa;3. Department of Political Science and Center for Social Policy, University of New Mexico (G Sanchez), Albuquerque, NM;4. Department of Pediatrics, UCLA Mattel Children''s Hospital, University of California at Los Angeles (PG Szilagyi) |
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| Abstract: | BackgroundReceipt of recommended well-child care is lowest for children without insurance, many of whom receive care in community health centers (CHCs).ObjectiveTo understand if there is an association between parent preventive care and their children's well-child visits.MethodsWe used electronic health record data to identify children and link them to parents both seen in an OCHIN network (CHC; n = 363 clinics from 17 states), randomly selected a child aged 3 to 17 with ≥1 ambulatory visit between 2015 and 2018. We employed a retrospective, cohort study design and used general estimating equations Poisson regression to estimate yearly rates of well-child visits based on parent preventive care adjusted for relevant covariates and stratified by child age for 3 linked samples: mother only, father only, and two parents.ResultsWe included 75,398 linked mother only pairs, 12,438 in our father only, and 4,156 in our 2-parent sample. Children in the mother only sample had a 6% greater rate of yearly well-child visits when their mother received preventive care (adjusted rate ratio ARR] = 1.06; 95% CI = 1.03–1.08) compared to no preventive care. Children in the father only sample had a 7% greater rate of yearly well-child visits when their father received preventive care (ARR = 1.07; 95% CI = 1.04–1.11) versus no preventive care. Children in the two parent sample had an 11% greater rate of yearly well-child visits when both parents received preventive care (ARR = 1.11; 95% CI = 1.03–1.19) compared to neither receiving preventive care.ConclusionsThese findings suggest focusing on receipt of healthcare for the whole family may improve well-child visit rates. |
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