Attendance patterns in well-child visits across diverse pediatric populations, Midwestern United States

Abstract

Objective

Routine well-child visits (WCVs) are essential for monitoring child health; however, substantial differences exist in attendance, particularly among non-Hispanic Black families. We quantified these disparities within a single healthcare system, comparing two distinct pediatric practice groups: one serving primarily non-Hispanic Black and one serving primarily non-Hispanic white children.

Method

This retrospective analysis included patients born in 2022 with at least one WCV in their first 15 months of life using electronic medical records from a healthcare system in the Chicago area. We assessed WCVs against American Academy of Pediatrics guidelines, using Pearson's chi-squared tests to compare attendance rates and logistic regression to calculate adjusted odds ratios (aOR) and 95 % confidence intervals (CI) for factors associated with attending 6 or more WCVs.

Results

Among 2567 eligible patients, 51.7 % were from Site 1 (predominantly non-Hispanic Black) and 48.3 % were from Site 2 (predominantly non-Hispanic white). Among Site 1 patients, 83.3 % attended six or more WCVs compared to 91.6 % from Site 2 (p < 0.001), with lower attendance at Site 1 observed starting at 2 months (aOR 0.55, 95 % CI 0.38, 0.80). Across all patients, patients with Medicaid insurance had 61 % lower odds of attending 6+ WCVs compared to commercially insured patients (aOR 0.39, 95 % CI 0.26, 0.58).

Conclusion

These findings highlight critical differences in WCV attendance among children within the same healthcare system. Lower at the site serving primarily non-Hispanic Black children may be attributable to barriers to healthcare access, including socioeconomic challenges and implicit bias in healthcare delivery.