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Adherence with recommended well-child visits has grown, but large gaps persist among various socioeconomic groups

Salam Abdus1, Thomas M Selden

  • 1Social and Scientific Systems, Silver Spring, Maryland, USA.

Health Affairs (Project Hope)
|March 6, 2013
PubMed

Insights

Preventive health care for children improved, but disparities in well-child visit adherence persisted and widened. Federal policies like the Affordable Care Act aim to address these gaps in child wellness.

Area of Science:

  • Pediatrics
  • Health Services Research
  • Public Health Policy

Background:

  • Federal policy aims to enhance preventive health care for children.
  • Understanding trends in adherence to American Academy of Pediatrics well-child visit recommendations is limited.

Purpose of the Study:

  • To examine trends in adherence to well-child visit recommendations from 1996-2008.
  • To determine if adherence disparities across population subgroups narrowed or widened over time.

Main Methods:

  • Analysis of the 1996-2008 Medical Expenditure Panel Surveys.
  • Examination of trends in the ratio of actual to recommended well-child visits.
  • Assessment of changes in adherence differences across demographic and socioeconomic subgroups.

Main Results:

  • The ratio of actual to recommended well-child visits increased from 46.3% (1996-98) to 58.9% (2007-08).
  • Significant adherence differences existed at baseline across income, race/ethnicity, parent education, region, insurance, and usual source of care.
  • These disparities did not significantly narrow; some widened, including those related to parent education, insurance coverage, usual source of care, and region.

Conclusions:

  • While overall adherence to well-child visits improved, the gains were unevenly distributed.
  • Existing disparities in preventive care access persisted and, in some cases, worsened.
  • Policies like the Affordable Care Act are crucial for expanding coverage and improving preventive service delivery and measurement for children.

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