In early childhood, continuous care by 1 doctor improves delivery of health screenings

Mar 03, 2008

Children examined by the same doctor during their first six months of life are more likely to receive appropriate preventive health screenings -- for lead poisoning, anemia and tuberculosis -- by age two. Pediatric researchers said being cared for repeatedly by the same physician, often referred to as continuity of care, was a very important factor in the children they studied.

Researchers from The Children's Hospital of Philadelphia and The University of Pennsylvania reported on a study of 1,564 infants with Medicare insurance in the March issue of the journal Pediatrics. All the infants were born at three Philadelphia-area hospitals between July 1999 and March 2001 and received health care at over 120 different primary care offices. The finding applied to all office visits, in addition to “well child” visits, and children were followed for the first two years of life.

“Continuity of care may be of particular importance to vulnerable pediatric patients, such as those insured through the Medicaid program,” said Evaline Alessandrini, M.D., M.S.C.E., a pediatrician at Children’s Hospital and principal investigator of the study. “All health care visits, not just well child visits, are important in establishing relationships with families and meeting children's health care needs.”

Children most at risk, such as those from urban, low-income families, often don’t receive proper screening for lead toxicity, anemia and tuberculosis. Lead toxicity in early life can lead to lower intelligence later. Iron deficiency anemia can cause problems with movement and damage sight or hearing. Tuberculosis, while becoming less common, can have serious complications for children.

Attempts to improve outcomes should focus not only on increasing the number of visits to a primary care provider, but also reducing the number of pediatricians treating the child over time. A next step is to identify which children are most at risk of not receiving repeat care from the same doctor.

“In 2008, there’s a lot of discussion about the purpose of primary care and the benefits children achieve by having a regular doctor,” said Alessandrini. “We don’t want to forget the basics and if there are simple ways to ensure those aspects of primary care are met, then we should find ways to get them done.”

Although they examined duration of office hours and other practice specific information, the researchers did not determine whether a medical office uses electronic records to alert providers when it was time for screening, a method shown in past studies to improve vaccination rates and other services.

Also, the authors caution that increasing continuity of care is difficult because certain office visits require immediate medical attention and parents may prefer their child see the first physician available rather than wait to see their regular doctor. Future studies are needed to monitor patients over a longer period of time and in a wider geographic region, the authors said.

Source: Children's Hospital of Philadelphia

Explore further: Mexican Americans confront high disability rates in later life

add to favorites email to friend print save as pdf

Related Stories

Racism 'a factor' in child removal

Mar 17, 2015

For nearly three excruciating days, Albert Hartnett had no clue where his 18-month-old daughter, Stella, was being kept.

IBM's 'Jeopardy!' champ ventures to new worlds

Mar 13, 2015

IBM Watson initially won fame as the artificially intelligent computer system that won $1 million for whipping former "Jeopardy!" champs Ken Jennings and Brad Rutter on the televised game show in 2011.

Florentine basilica gets high-tech physical

Feb 26, 2015

Late last year, two University of California, San Diego students set out for Florence, Italy, to diagnose a patient that had no prior medical record, couldn't be poked or prodded in any way, and hadn't been ...

Recommended for you

Top European beers to show calorie counts

8 hours ago

Beer drinkers in Europe will soon be able to find out the calorie count on their drinks after four of the world's biggest brewers said Thursday that they will list the information.

One in four high school seniors now try water pipes

13 hours ago

Despite declines in the number of youths who smoke cigarettes, hookah or water pipe use continues to rise among Canadian youth, a new study from the University of Waterloo reports. Published Monday in Cancer Ca ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.