title: Disparities in Health Supervision for Children With Down Syndrome.
abstract: Increasing evidence suggests children with Down syndrome do not receive recommended health care services. We retrospectively assessed adherence to the 2001 American Academy of Pediatrics health supervision guidelines for 124 children with Down syndrome. Cervical spine radiographs were completed for 94% of children, often preoperatively. Adherence to complete blood count recommendations was 55% (95% CI 44% to 66%); lower for males ( P = .01) and children with private medical insurance ( P = .04). Adherence to thyroid function recommendations was 61% (95% CI 54% to 67%); higher for children seen by a pediatrician ( P = .002) and with known thyroid disease ( P < .0001). Adherence to audiology and ophthalmology recommendations was 33% (95% CI 27% to 40%) and 43% (95% CI 37% to 50%), respectively. Adherence rates were higher for children referred to an otolaryngologist ( P = .0002) and with known eye disease ( P < .0001). Future efforts should identify barriers to care and improve adherence to recommended screening.
authors.affiliation: 1 American Family Children's Hospital, Madison, WI, USA.|2 University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Katie
authors.initials: K
authors.lastname: Williams
authors.affiliation: 1 American Family Children's Hospital, Madison, WI, USA.|2 University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: David
authors.initials: D
authors.lastname: Wargowski
authors.affiliation: 3 University of Wisconsin-Madison, Madison, WI, USA.
authors.forename: Jens
authors.initials: J
authors.lastname: Eickhoff
authors.affiliation: 1 American Family Children's Hospital, Madison, WI, USA.|2 University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Wald
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult
keywords: Down syndrome; clinical guidelines; health disparities; health supervision; primary care