The Impact of Infant Well-Child Care Compliance and Social Risks on Emergency Department Utilization

Clin Pediatr (Phila). 2017 Sep;56(10):920-927. doi: 10.1177/0009922817706145. Epub 2017 Apr 24.

Abstract

Deployment of medical and social services at well-child visits promotes child health. A retrospective review of the electronic health record was conducted for infants presenting for their "newborn" visit over a 2-year period at an urban, academic primary care center. Primary outcomes were time to first emergency department (ED) visit, number of ED visits (emergent or nonemergent), and number of nonemergent ED visits by 2 years of life. Records from 212 consecutive newborns were evaluated-59.9% were black/African American and 84.4% publicly insured. A total of 72.6% visited the ED by 2 years of life. Sixty percent received ≥5 well-child visits by 14 months; 25.9% reported ≥1 social risk. There were no statistically significant associations between number of completed well-child visits, or reported social risks, and ED utilization. Renewed focus on preventive care delivery and content and its effect on ED utilization, and other patient outcomes, is warranted.

Keywords: emergency department; social determinants of health; well-child care.

MeSH terms

  • Child Health Services / statistics & numerical data*
  • Electronic Health Records
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Infant
  • Infant Care / methods
  • Infant Care / statistics & numerical data*
  • Infant, Newborn
  • Male
  • Office Visits / statistics & numerical data*
  • Parents
  • Patient Compliance / statistics & numerical data*
  • Pediatrics / methods
  • Pediatrics / statistics & numerical data
  • Preventive Health Services / methods
  • Preventive Health Services / statistics & numerical data*
  • Primary Health Care / methods
  • Primary Health Care / statistics & numerical data
  • Retrospective Studies
  • Risk
  • Social Work / statistics & numerical data
  • Urban Population