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Are well-child visits a risk factor for subsequent influenza-like illness visits?
Jacob E Simmering1, Linnea A Polgreen, Joseph E Cavanaugh
1Department of Pharmacy Practice and Science, University of Iowa, Iowa City, Iowa.
Insights
Well-child visits may increase the risk of subsequent influenza-like illness (ILI) visits within a family. This finding suggests a need for enhanced infection control in clinics to prevent ILI transmission.
Area of Science:
- Pediatric Health
- Infectious Disease Epidemiology
- Public Health
Background:
- Well-child visits are routine healthcare encounters for monitoring child development.
- Influenza-like illness (ILI) represents a significant public health concern, particularly during seasonal outbreaks.
- Understanding transmission dynamics in healthcare settings is crucial for preventing secondary infections.
Purpose of the Study:
- To investigate whether well-child visits act as a risk factor for subsequent influenza-like illness (ILI) visits within a family.
- To quantify the association between well-child visits and ILI transmission in a family setting.
Main Methods:
- Retrospective cohort study utilizing data from the Medical Expenditure Panel Survey (1996-2008).
- Analysis included 84,595 families, identifying weeks with well-child visits and ILI visits.
- Logistic regression models were employed to assess the association, controlling for various demographic and seasonal factors.
Main Results:
- A positive association was found between well-child visits and subsequent ILI office visits within a family (Odds Ratio = 1.54).
- This association suggests an increased risk of ILI following a well-child visit.
- The estimated annual excess cases of ILI in the U.S. due to this risk factor are substantial, with significant associated costs.
Conclusions:
- Findings indicate that ambulatory clinics should reinforce infection control measures to mitigate ILI spread.
- Consideration should be given to scheduling well-child visits to minimize overlap with peak influenza seasons.
- Implementing these strategies may help reduce ILI transmission and associated healthcare costs.
Objective:
To determine whether well-child visits are a risk factor for subsequent influenza-like illness (ILI) visits within a child's family.
Design:
Retrospective cohort.
Methods:
Using data from the Medical Expenditure Panel Survey from the years 1996-2008, we identified 84,595 families. For each family, we determined those weeks in which a well-child visit or an ILI visit occurred. We identified 23,776 well-child-visit weeks and 97,250 ILI-visit weeks. We fitted a logistic regression model, where the binary dependent variable indicated an ILI clinic visit in a particular week. Independent variables included binary indicators to denote a well-child visit in the concurrent week or one of the previous 2 weeks, the occurrence of the ILI visit during the influenza season, and the presence of children in the family in each of the age groups 0-3, 4-7, and 8-17 years. Socioeconomic variables were also included. We also estimated the overall cost of well-child-exam-related ILI using data from 2008.
Results:
We found that an ILI office visit by a family member was positively associated with a well-child visit in the same or one of the previous 2 weeks (odds ratio, 1.54). This additional risk translates to potentially 778,974 excess cases of ILI per year in the United States, with a cost of $500 million annually.
Conclusions:
Our results should encourage ambulatory clinics to strictly enforce infection control recommendations. In addition, clinics could consider time-shifting of well-child visits so as not to coincide with the peak of the influenza season.
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