Brown J, Melinkovich P, Gitterman B, Ricketts S
Department of Community Health Services, Denver Health and Hospitals.
Am J Dis Child. 1993 Oct;147(10):1081-4. doi: 10.1001/archpedi.1993.02160340067016.
To determine the percentage of patients in a large pediatric practice in compliance with national recommendations regarding immunizations and well-child care visits.
Chart review. Point estimates with 95% confidence intervals were determined for reviewed charts in compliance with recommendations of the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention and schedule of well-child care visits, screening, and anticipatory guidance recommended by the American Academy of Pediatrics (AAP).
A large, multisite urban public pediatric practice.
Three hundred eighty-six infants and children (aged 0 to 60 months) who had a total of 7595 patient visits.
A random sample of charts.
There was a large discrepancy in compliance for patients aged 0 to 23 months in ACIP-recommended immunizations (90.5% +/- 3.9%) vs AAP-recommended well-child care visits (37.6% +/- 6.4%) and for patients aged 24 to 60 months in ACIP-recommended immunizations (87.8% +/- 5.1%) vs AAP-recommended well-child care visits (31.0% +/- 7.1%).
The data suggest that immunization alone does not ensure that children will receive all aspects of preventive care, raising questions about the practicality of the current AAP recommendations for preventive pediatric health care.
确定一家大型儿科诊所中符合国家免疫接种和儿童健康保健就诊建议的患者比例。
图表回顾。针对符合疾病控制与预防中心免疫实践咨询委员会（ACIP）建议以及美国儿科学会（AAP）推荐的儿童健康保健就诊、筛查和预期指导时间表的回顾图表，确定了点估计值及其95%置信区间。
一家大型的、多地点的城市公立儿科诊所。
386名婴儿和儿童（年龄在0至60个月之间），共进行了7595次患者就诊。
图表随机抽样。
0至23个月龄患者在ACIP推荐的免疫接种方面的依从性（90.5%±3.9%）与AAP推荐的儿童健康保健就诊方面的依从性（37.6%±6.4%）存在较大差异；24至60个月龄患者在ACIP推荐的免疫接种方面的依从性（87.8%±5.1%）与AAP推荐的儿童健康保健就诊方面的依从性（31.0%±7.1%）也存在较大差异。
数据表明，仅进行免疫接种并不能确保儿童获得预防保健的所有方面，这引发了对当前AAP预防儿科保健建议实用性的质疑。
