Association of Parent Preventive Care with their Child's Recommended Well-Child Visits.

Abstract

Receipt of recommended well-child care is lowest for children without insurance, many of whom receive care in community health centers (CHCs). To understand if there is an association between parent preventive care and their children's well-child visits. We used electronic health record data to identify children and link them to parents both seen in an OCHIN network (CHC; n=363 clinics from 17 states), randomly selected a child aged 3 to 17 with ≥1 ambulatory visit between 2015 and 2018. We employed a retrospective, cohort study design and used general estimating equations Poisson regression to estimate yearly rates of well-child visits based on parent preventive care adjusted for relevant covariates and stratified by child age for 3 linked samples: mother only, father only, and two parents. We included 75,398 linked mother only pairs, 12,438 in our father only, and 4,156 in our 2-parent sample. Children in the mother only sample had a 6% greater rate of yearly well-child visits when their mother received preventive care (adjusted rate ratio [ARR]=1.06; 95% CI=1.03-1.08) compared to no preventive care. Children in the father only sample had a 7% greater rate of yearly well-child visits when their father received preventive care (ARR=1.07; 95% CI=1.04-1.11) versus no preventive care. Children in the two parent sample had an 11% greater rate of yearly well-child visits when both parents received preventive care (ARR=1.11; 95% CI=1.03-1.19) compared to neither receiving preventive care. These findings suggest focusing on receipt of healthcare for the whole family may improve well-child visit rates.