Abstract
Introduction
This study examines correlates of past-year well-child visit attendance, reasons for
choosing to receive care at a health center, and patient experience among pediatric
federally qualified health center users.
Method
This observational study used cross-sectional 2009 Health Center Patient Survey data.
Descriptive statistics, bivariate analysis, and multivariable models were utilized.
Results
This study found that 83.0% of children who visited a health center in the past year
had a well-child visit in the past year and 88.5% had a usual source of care, with
no disparities based on race/ethnicity or insurance status. A usual source of care,
especially a health center, enhanced well-child visit attendance. The top reasons
for seeking care at a health center include convenience (31.6%), quality (24.5%),
accessibility (17.7%), and co-located nonmedical services (11.5%).
Discussion
Well-child visit attendance is high but there is room for improvement, particularly
among patients who lack a usual source of care.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric Health CareAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Adherence with recommended well-child visits has grown, but large gaps persist among various socioeconomic groups.Health Affairs. 2013; 32: 508-515
- Medical home for adolescents: Low attainment rates for those with mental health problems and other vulnerable groups.Academic Pediatrics. 2013; 13: 113-121
- Patient health literacy universal precautions toolkit and implementation guide.2015 (Retrieved from)
- Annual report on health care for children and youth in the United States: Trends in racial/ethnic, income, and insurance disparities over time, 2002-9.Academic Pediatrics. 2013; 13: 191-203
- Accountable care for the poor and underserved: Minnesota's Hennepin Health model.American Journal of Public Health. 2015; 105: 622-624
- Development of a bundle measure for preventive service delivery to infants in primary care.Journal of Evaluation in Clinical Practice. 2015; 21: 642-648
- No usual source of health care among children.2009 (Retrieved from)
- Healthy People 2020 topics and objectives, social determinants of health.2015 (Retrieved from)
- Preventive care for children in the United States: Quality and barriers.Annual Review of Public Health. 2006; 27: 491-515
- Children's compliance with American Academy of Pediatrics' well-child care visit guidelines and the early detection of autism.Journal of Autism and Developmental Disorders. 2013; 43: 2844-2854
- Receipt of preventive care among adults: Insurance status and usual source of care.American Journal of Public Health. 2003; 93: 786-791
- Effect of expanding Medicaid for parents on children's health insurance coverage: Lessons from the Oregon experiment.JAMA Pediatrics. 2015; 169: e143-e145
- A usual source of care: Supplement or substitute for health insurance among low-income children?.Medical Care. 2008; 46: 1041-1048
- A medical home versus temporary housing: The importance of a stable usual source of care.Pediatrics. 2009; 124: 1363-1371
- The case for synergy between a usual source of care and health insurance coverage.Journal of General Internal Medicine. 2011; 26: 1059-1066
- Parent and child usual source of care and children's receipt of health care services.Annals of Family Medicine. 2011; 9: 504-513
- Financial barriers to care among low-income children with asthma: Health care reform implications.JAMA Pediatrics. 2014; 168: 649-656
- Effectiveness of compliance with pediatric preventive care guidelines among Medicaid beneficiaries.Pediatrics. 2001; 108: 90-97
- 2013 Data snapshot.2015 (Retrieved from)
- Community health centers: medical homes for children?.Academic Pediatrics. 2013; 13: 436-442
- Usual source of care and unmet need among vulnerable children: 1998-2006.Pediatrics. 2009; 123: e214-e219
- Parents' health and demographic characteristics predict noncompliance with well-child visits.Journal of the American Board of Family Medicine. 2004; 17: 324-331
- Access to mental health services among patients at health centers and factors associated with unmet needs.Journal of Health Care for the Poor and Underserved. 2014; 25: 425-436
- Access to oral health care among health center patients: The role of health centers in addressing disparities and expanding access.American Journal of Public Health. 2013; 103: 488-493
- Opting out of Medicaid expansion: Impact on encounters with behavioral health specialty staff in community health centers.Psychiatric Services. 2015; (Advance online publication http://dx.doi.org/10.1176/appi.ps.201400361)
- New federal policy initiatives to boost health literacy can help the nation move beyond the cycle of costly ‘crisis care’.Health Affairs. 2012; 31: 434-443
- A proposed ‘health literate care model’ would constitute a systems approach to improving patients' engagement in care.Health Affairs. 2013; 32: 357-367
- Safety-net providers after health care reform: Lessons from Massachusetts.Archives of Internal Medicine. 2011; 171: 1379-1384
- Funding growth drives community health center services.Health Affairs. 2010; 29: 289-296
- Protocol for responding to and assessing patient assets, risks, and experiences (PRAPARE).2015 (Retrieved from)
- Well-child care: Looking back, looking forward.Pediatric Annals. 2008; 37: 143-151
- Compliance with well-child visit recommendations: Evidence from the Medical Expenditure Panel Survey, 2000-2002.Pediatrics. 2006; 118: e1766-e1778
- Reducing disparities in access to primary care and patient satisfaction with care: The role of health centers.Journal of Health Care for the Poor and Underserved. 2013; 24: 56-66
- The quality of primary care experienced by health center patients.Journal of the American Board of Family Medicine. 2013; 26: 768-777
- Racial/ethnic and socioeconomic disparities in access to care and quality of care for US health center patients compared with non-health center patients.Journal of Ambulatory Care Management. 2009; 32: 342-350
- A profile of community health center patients: Implications for policy. Kaiser Family Foundation Issue Brief, December 2013.2013 (Retrieved from)
- Disparities in primary care for vulnerable children: The influence of multiple risk factors.Health Services Research. 2006; 41: 507-531
- Use of collocated multidisciplinary services to address family psychosocial needs at an urban pediatric primary care clinic.Clinical Pediatrics. 2014; 54: 25-32
- Predictors of delayed or foregone needed health care for families with children.Pediatrics. 2012; 130: 1027-1037
Biography
Emily Jones, Social Science Analyst, Division of Behavioral Health and Intellectual Disabilities Policy, Office of Disability, Aging, and Long-Term Care Policy, Office of the Assistant Secretary for Planning and Evaluation, United States Department of Health and Human Services, Washington, DC, and Professorial Lecturer, Department of Health Policy and Management, George Washington University, Milken Institute School of Public Health and Health Services, Washington, DC.
Biography
Julia Zur, Postdoctoral Fellow, Department of Health Policy and Management, George Washington University, Milken Institute School of Public Health and Health Services, Washington, DC.
Biography
Linda Elam, Deputy Assistant Secretary, Office of Disability, Aging, and Long-Term Care Policy, Office of the Assistant Secretary for Planning and Evaluation, United States Department of Health and Human Services, Washington, DC.
Article info
Publication history
Published online: December 06, 2015
Footnotes
The RCHN Community Health Foundation funded Dr. Zur's fellowship.
Conflicts of interest: None to report.
Identification
Copyright
Published by Elsevier Inc. on behalf of the National Association of Pediatric Nurse Practitioners.
