Is underimunization a marker for insufficient utilization of preventive and primary care ?
To test the hypothesis that the underimmunization of young children is a marker for the lack of preventive and acute primary care.
Primary care center serving an impoverished population (90% Medicaid).
Historical cohort study (N=1178) of children aged 12 to 30 months that determined each child's immunization status ; anemia, tuberculosis, and lead screening status ; and office utilization history.
Screening delay was defined as missing a recommended screening by more than 3 months past the standard screening age.
Thirty-four percent of the population were underimmunized at 12 months of age.
Compared with fully immunized children, these children were at greater risk for screening delay : anemia, 38% vs 5%, lead, 69% vs 33%. These RRs increased with greater immunization delay.
Compared with fully immunized children, the underimmunized group made 47% fewer preventive health visits and fewer illness visits and had 50% more missed appointments.
Logistic regression, predicting anemia screening delay at 12 months of age, showed that underimmunization had an effect independent of utilization, with an odds ratio of 7.7. Underimmunization was a powerful, independent marker for inadequate health supervision in this population.
Implications : The current emphasis on immunizations has the benefit of targeting children at risk of lack of preventive and acute care.
Mots-clés Pascal : Etats Unis, Marqueur épidémiologique, Indicateur, Santé, Enfant, Immunisation, Vaccination, Utilisation, Service santé, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : United States, Epidemiological marker, Indicator, Health, Child, Immunization, Vaccination, Use, Health service, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0278556
Code Inist : 002B30A01A2. Création : 01/03/1996.