Missed opportunities in preventive pediatric health care. Immunizations or well-child care visits?
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.
Brown
J
J
Department of Community Health Services, Denver Health and Hospitals.
Melinkovich
P
P
Gitterman
B
B
Ricketts
S
S
D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003120:Colorado; D017408:Guidelines as Topic; D006801:Humans; D007114:Immunization / Q000592:standards / Q000706:statistics & numerical data*; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010349:Patient Compliance; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D014504:Urban Health