[Family health center follow-up in preschool children]
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1Assoc. for the Development and Improvement of Services for Handicapped and Retarded in Israel, Haifa.
Insights
Follow-up rates at family health centers (FHC) significantly decline with age, dropping from 97% at 6 months to 33% by 3.5 years. Factors like maternal education and child health influence attendance, necessitating a reevaluation of FHC services.
Area of Science:
- Pediatrics
- Public Health
- Family Medicine
Background:
- Family health centers (FHC) are crucial for monitoring child development and managing chronic conditions.
- National studies are essential for understanding healthcare access and utilization patterns in pediatric populations.
Purpose of the Study:
- To determine the duration of follow-up care at family health centers (FHC) for preschool children.
- To identify factors associated with attendance and dropout rates in FHC services.
Main Methods:
- Analysis of a national prevalence study sample of 8,702 children from the 1980 Jewish birth cohort.
- Retrospective follow-up rate calculation based on age, maternal, and child characteristics.
Main Results:
- FHC attendance significantly decreased with age, from 97% at 6 months to 33% at 3.5 years.
- Higher attendance at age 3 was linked to maternal origin (Asian), lower maternal education, younger maternal age, first-born status, southern rural residence, and diagnosed medical problems.
- Children with very low birth weight (<1,500g) had higher dropout rates in the first year.
Conclusions:
- Current FHC follow-up durations may not align with evolving population needs.
- Reevaluation of FHC purpose, content, and efficiency is recommended in response to educational and technological advancements.
Abstract:
The duration of follow-up at family health centers (FHC) was determined from a national prevalence study of chronic conditions and illnesses causing disability in preschool children. The sample comprised 8,702 children (12% of the 71,372 in the national Jewish birth cohort of 1980) who had reached the age of 3 years at the time of the study. The sample originated from 118 of the 870 FHC in areas of Jewish population which included FHC managed by municipalities, sick funds and the Ministry of Health. With increase in age there was a significant decrease in attendance at the FHC. Thus at 6 months of age, 97% of the sample attended the FHC, while at 3.5 years the follow-up rate had fallen to 33%. Children of mothers of Asian origin, of mothers with less than 10 years of schooling, and of mothers 19 years old or less on delivery, as well as first-born children, showed a higher rate of attendance at age 3 than the others. Higher attendance at age 3 was also registered in the south of the country, especially rural areas. More children with diagnosed medical problems attended at age 3 than healthy children. More children born with birth weights of 1,500 g or less dropped out of the FHC during their first year of life. The findings suggest that the purpose, content and efficiency of FHC be reexamined in light of changes in the needs of the target population due to educational and technological progress.