Biomaterial Database

Missed opportunities in preventive pediatric health care. Immunizations or well-child care visits? 1993

J Brown, and P Melinkovich, and B Gitterman, and S Ricketts

Department of Community Health Services, Denver Health and Hospitals.

OBJECTIVE To determine the percentage of patients in a large pediatric practice in compliance with national recommendations regarding immunizations and well-child care visits. METHODS Chart review. Point estimates with 95% confidence intervals were determined for reviewed charts in compliance with recommendations of the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention and schedule of well-child care visits, screening, and anticipatory guidance recommended by the American Academy of Pediatrics (AAP). METHODS A large, multisite urban public pediatric practice. METHODS Three hundred eighty-six infants and children (aged 0 to 60 months) who had a total of 7595 patient visits. METHODS A random sample of charts. RESULTS There was a large discrepancy in compliance for patients aged 0 to 23 months in ACIP-recommended immunizations (90.5% +/- 3.9%) vs AAP-recommended well-child care visits (37.6% +/- 6.4%) and for patients aged 24 to 60 months in ACIP-recommended immunizations (87.8% +/- 5.1%) vs AAP-recommended well-child care visits (31.0% +/- 7.1%). CONCLUSIONS The data suggest that immunization alone does not ensure that children will receive all aspects of preventive care, raising questions about the practicality of the current AAP recommendations for preventive pediatric health care.

UI	MeSH Term	Description	Entries
D007114	Immunization	Deliberate stimulation of the host's immune response. ACTIVE IMMUNIZATION involves administration of ANTIGENS or IMMUNOLOGIC ADJUVANTS. PASSIVE IMMUNIZATION involves administration of IMMUNE SERA or LYMPHOCYTES or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow).	Immunologic Stimulation,Immunostimulation,Sensitization, Immunologic,Variolation,Immunologic Sensitization,Immunological Stimulation,Sensitization, Immunological,Stimulation, Immunologic,Immunizations,Immunological Sensitization,Immunological Sensitizations,Immunological Stimulations,Sensitizations, Immunological,Stimulation, Immunological,Stimulations, Immunological,Variolations
D007115	Immunization Schedule	Schedule giving optimum times usually for primary and/or secondary immunization.	Immunization Schedules,Schedule, Immunization,Schedules, Immunization
D007223	Infant	A child between 1 and 23 months of age.	Infants
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D010044	Outpatient Clinics, Hospital	Organized services in a hospital which provide medical care on an outpatient basis.	Ambulatory Care Facilities, Hospital,Hospital Outpatient Clinics,Clinic, Hospital Outpatient,Clinics, Hospital Outpatient,Hospital Outpatient Clinic,Outpatient Clinic, Hospital
D010349	Patient Compliance	Voluntary cooperation of the patient in following a prescribed regimen.	Client Adherence,Client Compliance,Non-Adherent Patient,Patient Adherence,Patient Cooperation,Patient Noncompliance,Patient Non-Adherence,Patient Non-Compliance,Patient Nonadherence,Therapeutic Compliance,Treatment Compliance,Adherence, Client,Adherence, Patient,Client Compliances,Compliance, Client,Compliance, Patient,Compliance, Therapeutic,Compliance, Treatment,Cooperation, Patient,Non Adherent Patient,Non-Adherence, Patient,Non-Adherent Patients,Non-Compliance, Patient,Nonadherence, Patient,Noncompliance, Patient,Patient Non Adherence,Patient Non Compliance,Patient, Non-Adherent,Therapeutic Compliances,Treatment Compliances
D011314	Preventive Health Services	Services designed for HEALTH PROMOTION.	Health Services, Preventive,Preventive Health,Preventive Health Care,Preventive Health Programs,Preventive Programs,Services, Preventive Health,Care, Preventive Health,Health Care, Preventive,Health Program, Preventive,Health Programs, Preventive,Health Service, Preventive,Health, Preventive,Preventive Health Program,Preventive Health Service,Preventive Program,Program, Preventive,Program, Preventive Health,Programs, Preventive,Programs, Preventive Health,Service, Preventive Health
D002662	Child Health Services	Organized services to provide health care for children.	Infant Health Services,Child Services, Health,Health Services, Child,Health Services, Infant,Infant Services, Health,Services, Child Health,Services, Infant Health,Child Health Service,Health Service, Child,Health Service, Infant,Infant Health Service,Service, Child Health,Service, Infant Health
D002675	Child, Preschool	A child between the ages of 2 and 5.	Children, Preschool,Preschool Child,Preschool Children
D003120	Colorado	State bounded on the north by Wyoming and Nebraska, on the east by Kansas and Nebraska, on the south by New Mexico and Oklahoma, and on the west by Utah.