Oregon Health & Science University (H Angier, J Kaufmann, J Heintzman, L Moreno, and M Marino), Portland, Ore.
Oregon Health & Science University (H Angier, J Kaufmann, J Heintzman, L Moreno, and M Marino), Portland, Ore; OCHIN, Inc. (J Heintzman, J O'Malley, and S Giebultowicz), Portland, Ore.
Acad Pediatr. 2022 Nov-Dec;22(8):1422-1428. doi: 10.1016/j.acap.2022.03.019. Epub 2022 Apr 1.
Receipt of recommended well-child care is lowest for children without insurance, many of whom receive care in community health centers (CHCs).
To understand if there is an association between parent preventive care and their children's well-child visits.
We 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.
We 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.
These findings suggest focusing on receipt of healthcare for the whole family may improve well-child visit rates.
未参保儿童接受推荐的儿童保健服务的比例最低，其中许多人在社区卫生中心（CHC）接受治疗。
了解父母的预防保健与子女定期儿童保健就诊之间是否存在关联。
我们使用电子健康记录数据来识别在 OCHIN 网络（CHC；来自 17 个州的 363 个诊所）中就诊的儿童及其父母，并随机选择一名在 2015 年至 2018 年期间至少有 1 次门诊就诊的 3 至 17 岁儿童。我们采用回顾性队列研究设计，使用一般估计方程泊松回归，根据父母预防保健情况调整相关协变量，并根据 3 个关联样本（仅母亲、仅父亲和双亲）的儿童年龄进行分层，估算每年定期儿童保健就诊率。
我们纳入了 75398 对关联的仅母亲样本、12438 对仅父亲样本和 4156 对双亲样本。与未接受预防保健的儿童相比，仅母亲样本中母亲接受预防保健的儿童每年定期儿童保健就诊率增加了 6%（调整后的比率比 [ARR] = 1.06；95%CI = 1.03-1.08）。仅父亲样本中父亲接受预防保健的儿童每年定期儿童保健就诊率增加了 7%（ARR = 1.07；95%CI = 1.04-1.11），而未接受预防保健的儿童则没有增加。双亲样本中父母双方均接受预防保健的儿童每年定期儿童保健就诊率增加了 11%（ARR = 1.11；95%CI = 1.03-1.19），而未接受预防保健的儿童则没有增加。
这些发现表明，关注整个家庭的医疗保健服务的获得情况可能会提高定期儿童保健就诊率。
