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Missing Well-Child Visits Risky for Chronically Ill Children

Tied to higher risk of hospitalization, especially if continuity of care is low

THURSDAY, Nov. 4 (HealthDay News) -- Young children with chronic conditions who get regular well-child care (WCC) are less likely to be hospitalized than those who do not get regular care, especially if the children also have high continuity of care (COC), according to a study in the November issue of the Archives of Pediatrics & Adolescent Medicine.

Jeffrey O. Tom, M.D., of the University of Hawaii in Honolulu, and colleagues studied a group of 36,944 children (aged 3.5 years or younger), including 8,921 children with chronic diseases. The researchers sought to determine if the children with the chronic conditions who adhered to the recommended WCC visit schedule had fewer ambulatory care-sensitive hospitalizations (ACSH) than those who didn't. The researchers also evaluated the impact of COC on ACSH.

The researchers found that those with chronic disease had a higher proportion of ACSH than those without chronic disease (7 versus 3 percent). The children with chronic disease who had the lowest adherence to the WCC visit schedule (0 to 25 percent) had a 90 percent increased risk of ACSH compared to children with the highest adherence (75 to 100 percent). Also, among children with chronic disease who had the lowest COC, the risk of ACSH was more than two-fold greater (hazard ratio, 2.4) than for those in the highest COC category.

"For children with chronic disease, both low WCC visit adherence and COC are independently associated with an increased risk of ACSH. Providing access to a consistent source of primary care appears to be important to this vulnerable population," the authors write.

A co-author disclosed working for the health insurer that provided the data used in the study.

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