Continuous Doctor Care Key to Childhood Screenings

MONDAY March 10, 2008 -- Children cared for by the same doctor during their first six months of life are more likely than those examined by different doctors to receive proper screening for lead poisoning, anemia and tuberculosis by age 2, a U.S. study finds.

The study looked at 1,564 infants covered by Medicare. All the children were born at three Philadelphia-area hospitals between July 1999 and March 2001, and received health care at more than 120 different primary-care offices.

Lead toxicity in infants can lead to low intelligence later in life, iron-deficiency anemia can cause movement problems and damage sight or hearing, and tuberculosis can have serious complications for children.

Children most at risk -- such as those from urban, low-income families -- often don't receive proper screening for these problems, the study authors noted.

"Continuity of care may be of particular importance to vulnerable pediatric patients, such as those insured through the Medicaid program," principal investigator Dr. Evaline Alessandrini, a pediatrician at the Children's Hospital of Philadelphia, said in a prepared statement. "All health-care visits, not just well-child visits, are important in establishing relationships with families and meeting children's health-care needs."

She and her colleagues said efforts to improve infant outcomes should focus not only on increasing the number of visits to a primary-care doctor, but also reducing the number of pediatricians who treat a child. It's also important to identify which children are most at risk of not receiving continuity of care.

"In 2008, there's a lot of discussion about the purpose of primary care and the benefits children achieve by having a regular doctor. We don't want to forget the basics and, if there are simple ways to ensure those aspects of primary care are met, then we should find ways to get them done," Alessandrini said.

The study was published in the March issue of Pediatrics.

More information

The March of Dimes has more about screening tests for infants.

Posted: March 2008


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