Lawson Nikki R, Klein Melissa D, Ollberding Nicholas J, Wurster Ovalle Victoria, Beck Andrew F
1 University of Cincinnati College of Medicine, Cincinnati, OH, USA.
2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Clin Pediatr (Phila). 2017 Sep;56(10):920-927. doi: 10.1177/0009922817706145. Epub 2017 Apr 24.
Deployment of medical and social services at well-child visits promotes child health. A retrospective review of the electronic health record was conducted for infants presenting for their "newborn" visit over a 2-year period at an urban, academic primary care center. Primary outcomes were time to first emergency department (ED) visit, number of ED visits (emergent or nonemergent), and number of nonemergent ED visits by 2 years of life. Records from 212 consecutive newborns were evaluated-59.9% were black/African American and 84.4% publicly insured. A total of 72.6% visited the ED by 2 years of life. Sixty percent received ≥5 well-child visits by 14 months; 25.9% reported ≥1 social risk. There were no statistically significant associations between number of completed well-child visits, or reported social risks, and ED utilization. Renewed focus on preventive care delivery and content and its effect on ED utilization, and other patient outcomes, is warranted.
在健康儿童就诊时提供医疗和社会服务可促进儿童健康。在一家城市学术初级保健中心,对2年内前来进行“新生儿”就诊的婴儿的电子健康记录进行了回顾性审查。主要结局指标为首次急诊就诊时间、急诊就诊次数(紧急或非紧急)以及2岁前非紧急急诊就诊次数。对212例连续新生儿的记录进行了评估,其中59.9%为黑人/非裔美国人,84.4%有公共保险。到2岁时,共有72.6%的儿童去过急诊。60%的儿童在14个月时接受了≥5次健康儿童就诊;25.9%报告有≥1项社会风险。完成的健康儿童就诊次数或报告的社会风险与急诊利用之间无统计学显著关联。有必要重新关注预防性保健的提供、内容及其对急诊利用和其他患者结局的影响。