Primary Care and Home Visiting Utilization Patterns among At-Risk Infants

Area of Science:

• Pediatrics
• Public Health
• Health Services Research

Background:

• Well-child care (WCC) is crucial for monitoring infant health and development.
• At-risk infants may face barriers to consistent WCC utilization.
• Home visiting programs aim to support families and improve health outcomes.

Purpose of the Study:

• To examine WCC visit patterns in the first year of life for at-risk infants.
• To determine the relationship between home visiting program enrollment and WCC utilization.
• To identify factors associated with adherence to recommended WCC schedules.

Main Methods:

• Retrospective cohort study of infants (≥34 weeks gestation) using linked administrative data (2010-2014).
• Bivariate and multivariable Poisson regression to assess WCC visits and home visiting enrollment.
• Latent class analysis to characterize WCC attendance patterns.
• Multivariable logistic regression to evaluate home visiting's association with timely WCC adherence.

Main Results:

• The study included 11,936 infants; the average WCC visits were 4.1 in the first year.
• Among 3,910 eligible infants, only 28.5% enrolled in home visiting.
• Home visiting enrollment was associated with a higher likelihood of timely WCC attendance (aOR 1.27).

Conclusions:

• Infants enrolled in home visiting programs were more likely to adhere to timely well-child care schedules.
• Despite demonstrated benefits, a significant proportion of eligible at-risk infants were not enrolled in home visiting programs.
• Improving home visiting enrollment is essential to enhance WCC utilization among vulnerable populations.