Follow-up of the use of local health department clinics for preventive care among young children.

We followed 18,490 infants from their first visit to a county child health clinic (CHC) in Maryland through visits through their third year of age to investigate whether their continued use of the CHCs was related to their characteristics or to the services they were provided as an infant. We classified as provided services immunization, an Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) recommended screening, and number of visits. Immunization was associated with an increased percentage of infants who returned to the CHCs at two and three years of age. Half of the children, on the other hand, never returned to the clinics if they were not immunized as infants. These findings persisted, regardless of race, Medicaid status, completion of a screening, or number of visits in the first year of life. One-fifth of infants did not receive an immunization during one or more visits to CHCs in their first year. Failure to administer an immunization to infants appears to impede subsequent use of public health clinics for well child care.