Donna Cohen1, Andrew Coco. 1. The Research Institute at Lancaster General Hospital, Department of Family and Community Medicine, Lancaster General Hospital, Lancaster, PA 17604, USA. docohen@lancastergeneral.org
Abstract
PURPOSE: Provision of prenatal visits by family physicians decreased by 50% from 1995 to 2004. To determine the impact of this trend on the provision of well-child visits by these professionals, we measured trends in and factors associated with well-child visits by children younger than 2 years of age to family physicians and pediatricians. METHODS: Using the National Ambulatory Medical Care Survey, we identified well-child visits made in the first 2 years of life to family physicians and pediatricians between 1995 and 2007. The primary outcome measure was the trend in the proportion of such visits that were specifically to family physicians. RESULTS: We identified a total of 4,999 visits, representing 213 million well-child visits at the national level. Compared with visits to pediatricians, visits to family physicians were associated with higher rates of Medicaid insurance (P<.01) and were more likely to occur in non-metropolitan statistical area locations (P<.01) and in the Midwest and West geographic regions (P <.01). The percentage of all well-child visits for children younger than 2 years of age that were made to family physicians remained stable at 15% (95% confidence interval, 13%-17%; P = .29 for trend) during the study period. CONCLUSIONS: The diminishing role of family physicians in prenatal care has not been accompanied by a similar decrease in provision of well-child care to children younger than 2 years of age.
RCT Entities:
PURPOSE: Provision of prenatal visits by family physicians decreased by 50% from 1995 to 2004. To determine the impact of this trend on the provision of well-child visits by these professionals, we measured trends in and factors associated with well-child visits by children younger than 2 years of age to family physicians and pediatricians. METHODS: Using the National Ambulatory Medical Care Survey, we identified well-child visits made in the first 2 years of life to family physicians and pediatricians between 1995 and 2007. The primary outcome measure was the trend in the proportion of such visits that were specifically to family physicians. RESULTS: We identified a total of 4,999 visits, representing 213 million well-child visits at the national level. Compared with visits to pediatricians, visits to family physicians were associated with higher rates of Medicaid insurance (P<.01) and were more likely to occur in non-metropolitan statistical area locations (P<.01) and in the Midwest and West geographic regions (P <.01). The percentage of all well-child visits for children younger than 2 years of age that were made to family physicians remained stable at 15% (95% confidence interval, 13%-17%; P = .29 for trend) during the study period. CONCLUSIONS: The diminishing role of family physicians in prenatal care has not been accompanied by a similar decrease in provision of well-child care to children younger than 2 years of age.
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