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Temperature Measurement at Well-Child Visits in the United States
Rebecca Dang1, Alan R Schroeder1, Anisha I Patel1
1Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
Insights
Temperature checks occurred at nearly half of US well-child visits. Interventions increased when temperature was measured and fever was present, suggesting routine measurement may be valuable.
Area of Science:
- Pediatrics
- Public Health
- Health Services Research
Background:
- Temperature measurement is a common practice during pediatric visits.
- Understanding the frequency and predictors of temperature measurement is crucial for optimizing healthcare delivery.
- Interventions following temperature measurement and fever detection warrant investigation.
Purpose of the Study:
- To determine the frequency and predictors of temperature measurement during well-child visits in the United States.
- To report the rates of interventions associated with visits where temperature is measured and fever is detected.
Main Methods:
- Cross-sectional study analyzing 22,518 well-child visits from the National Ambulatory Medical Care Survey (2003-2015).
- Multivariable regression used to identify patient, provider/clinic, and seasonal factors associated with temperature measurement.
- Rates of interventions (e.g., complete blood count, urinalysis, antibiotic prescription, referral) were described based on temperature measurement and fever status (≥100.4 °F / 38.0 °C).
Main Results:
- Temperature was measured in 48.5% of well-child visits.
- Measurement was more frequent with non-pediatric providers, Hispanic and Black patients, and those with government insurance.
- Interventions were more common when temperature was measured (aOR 1.3) and fever was detected (aOR 3.8).
Conclusions:
- Nearly half of well-child visits included temperature measurement.
- Interventions were more prevalent when temperature was measured and fever was identified.
- The utility of routine temperature measurement in well-child visits requires further research.
Objective:
To determine the frequency and predictors of temperature measurement at well-child visits in the US and report rates of interventions associated with visits at which temperature is measured and fever is detected.
Study Design:
In this cross-sectional study, we analyzed 22 518 sampled well-child visits from the National Ambulatory Medical Care Survey between 2003 and 2015. We estimated the frequency of temperature measurement and performed multivariable regression to identify patient, provider/clinic, and seasonal factors associated with the practice. We described rates of interventions (complete blood count, radiograph, urinalysis, antibiotic prescription, and emergency department/hospital referral) by measurement and fever (temperature ≥100.4 °F, ≥38.0 °C) status.
Results:
Temperature was measured in 48.5% (95% CI 45.6-51.4) of well-child visits. Measurement was more common during visits by nonpediatric providers (aOR 2.0, 95% CI 1.6-2.5; reference: pediatricians), in Hispanic (aOR 1.9, 95% CI 1.6-2.3) and Black (aOR 1.5, 95% CI 1.2-1.9; reference: non-Hispanic White) patients, and in patients with government (aOR 2.0, 95% CI 1.7-2.4; reference: private) insurance. Interventions were more commonly pursued when temperature was measured (aOR 1.3, 95% CI 1.1-1.6) and fever was detected (aOR 3.8, 95% CI 1.5-9.4).
Conclusions:
Temperature was measured in nearly one-half of all well-child visits. Interventions were more common when temperature was measured and fever was detected. The value of routine temperature measurement during well-child visits warrants further evaluation.
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