Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA.
Department of Medicine, Children's Hospital, Boston, MA.
Fam Med. 2022 May;54(5):350-361. doi: 10.22454/FamMed.2022.922801.
Stay-at-home orders, social isolation recommendations, and fear of COVID-19 exposure have led to delays in children's preventive health services during the pandemic. Delays can lead to missed opportunities for early screening and detection of health problems, and increased risks for outbreaks of vaccine-preventable diseases. Understanding prevalence of and reasons for missed, delayed, or skipped preventive health services is important for developing strategies to achieve rapid catch-up of essential health services.
Using the Household Pulse Survey (n=37,064), a large, nationally-representative household survey fielded from April 14 to May 10, 2021, we examined prevalence of households with children who have missed, delayed, or skipped preventive health services, and factors associated with and reasons contributing to missed, delayed, or skipped preventive health services.
About one-quarter of parents had children who missed, delayed, or skipped preventive check-ups in the past year. Delays in children's preventive health services were more common among respondents with higher education, households with greater numbers of children, and children who learned remotely or did not participate in formal education. Main reasons attributed to delayed preventive health services were limited appointments at health providers' offices (42.9%), concern about COVID-19 exposure at health providers' offices (42.2%), and closed health providers' offices due to the pandemic (29.0%).
Physician office closures and concern about COVID-19 exposure resulted in over one-quarter of parents delaying preventive services for their children since the pandemic began. Coordinated efforts are needed to achieve rapid catch-up of preventive services and routine vaccines.
居家令、社交隔离建议和对 COVID-19 暴露的恐惧导致大流行期间儿童预防保健服务的延误。延迟会导致错过健康问题的早期筛查和检测机会,并增加疫苗可预防疾病爆发的风险。了解错过、延迟或跳过预防保健服务的普遍性和原因,对于制定策略以实现基本保健服务的快速追赶至关重要。
使用家庭脉搏调查(n=37064),这是一项大规模的、全国代表性的家庭调查,于 2021 年 4 月 14 日至 5 月 10 日进行,我们检查了有儿童错过、延迟或跳过预防保健服务的家庭的比例,以及与错过、延迟或跳过预防保健服务相关的因素和促成因素。
约四分之一的父母有孩子在过去一年中错过了、延迟了或跳过了预防检查。在受教育程度较高、子女较多的家庭以及远程学习或未参加正规教育的儿童中,儿童预防保健服务的延迟更为常见。导致预防保健服务延迟的主要原因是健康提供者办公室预约有限(42.9%)、担心健康提供者办公室的 COVID-19 暴露(42.2%)以及由于大流行而关闭健康提供者办公室(29.0%)。
由于医生办公室关闭和对 COVID-19 暴露的担忧,自大流行开始以来,超过四分之一的父母为孩子推迟了预防服务。需要协调努力,以实现预防服务和常规疫苗的快速追赶。