Impact of Healthcare Location Concordance on Receipt of Preventive Care Among Children Whose Parents have a Substance Use and/or Mental Health Diagnosis.

IF 3 Q1 PRIMARY HEALTH CARE
Joshua Martwick, Jorge Kaufmann, Steffani Bailey, Heather Angier, Nathalie Huguet, John Heintzman, Jean O'Malley, Laura Moreno, Jennifer E DeVoe
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Abstract

Aims: Children of parents with substance use and/or other mental health (SU/MH) diagnoses are at increased risk for health problems. It is unknown whether these children benefit from receiving primary care at the same clinic as their parents. Thus, among children of parents with >1 SU/MH diagnosis, we examined the association of parent-child clinic concordance with rates of well-child checks (WCCs) and childhood vaccinations.

Design: Retrospective cohort study using electronic health record (EHR) data from the OCHIN network of community health organizations (CHOs), 2010-2018. Setting: 280 CHOs across 17 states.

Participants/cases: 41,413 parents with >1 SU/MH diagnosis, linked to 65,417 children aged 0 to 17 years, each with >1 visit to an OCHIN clinic during the study period.

Measurements: Dependent variables: rates of WCCs during (1) the first 15 months of life, and (2) ages 3 to 17 years; vaccine completeness (3) by the age of 2, and (4) before the age of 18. Estimates were attained using generalized estimating equations Poisson or logistic regression.

Findings: Among children utilizing the same clinic as their parent versus children using a different clinic (reference group), we observed greater WCC rates in the first 15 months of life [adjusted rate ratio (aRR) = 1.06; 95% confidence interval (CI) = 1.02-1.10]; no difference in WCC rates in ages 3 to 17; higher odds for vaccine completion before age 2 [adjusted odds ratio (aOR) = 1.12; 95% CI = 1.03-1.21]; and lower odds for vaccine completion before age 18 (aOR = 0.88; 95% CI = 0.81-0.95).

Conclusion: Among children whose parents have at least one SU/MH diagnosis, parent-child clinic concordance was associated with greater rates of WCCs and higher odds of completed vaccinations for children in the youngest age groups, but not the older children. This suggests the need for greater emphasis on family-oriented healthcare for young children of parents with SU/MH diagnoses; this may be less important for older children.

医疗保健地点一致性对父母有药物使用和/或精神健康诊断的儿童接受预防性保健的影响。
目的:父母有药物使用和/或其他精神健康(SU/MH)诊断的儿童,出现健康问题的风险更高。目前还不清楚这些儿童是否能从与父母在同一诊所接受初级保健服务中获益。因此,我们在父母被诊断出患有 >1 种 SU/MH 疾病的儿童中,研究了亲子诊所一致性与儿童健康检查(WCC)率和儿童疫苗接种率之间的关系:设计:使用 2010-2018 年社区卫生组织 (CHOs) OCHIN 网络的电子健康记录 (EHR) 数据进行回顾性队列研究。地点:17 个州的 280 个社区卫生组织:41,413名父母有>1项SU/MH诊断,与65,417名0至17岁的儿童相关联,每个人在研究期间有>1次到OCHIN诊所就诊:因变量:(1) 出生后头 15 个月和 (2) 3 至 17 岁期间的 WCC 发生率;(3) 2 岁前和 (4) 18 岁前的疫苗接种完整率。采用广义估计方程泊松法或逻辑回归法进行估计:在与父母在同一诊所就诊的儿童和在不同诊所就诊的儿童(参照组)中,我们观察到出生后前 15 个月的 WCC 率更高[调整后比率比 (aRR) = 1.06;95% 置信区间 (CI) = 1.02-1.10]。10];3至17岁的WCC率没有差异;2岁前完成疫苗接种的几率更高[调整后的几率比(aOR)=1.12;95% 置信区间(CI)=1.03-1.21];18岁前完成疫苗接种的几率更低(aOR = 0.88;95% CI = 0.81-0.95):结论:在父母至少有一项 SU/MH 诊断的儿童中,亲子门诊的一致性与更高的 WCC 率以及最小年龄组儿童完成疫苗接种的几率有关,但与较大年龄组儿童无关。这表明,对于父母有 SU/MH 诊断的年幼儿童,需要更加重视以家庭为导向的医疗保健;而对于年长儿童,这一点可能不那么重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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