Primary preventive health care in children with heart disease.

In order to evaluate the preventive health care practices in children with heart disease, 499 families were surveyed in outpatient settings. Data were collected on 215 children with heart disease and 284 control children without known chronic illness. There was no significant difference between the groups in the type of primary physician utilized or frequency of visits to the primary care physician. Immunizations were incomplete in 32.7% of the children with heart disease compared to only 2.5% in the control group (P less than 0.0001). Among the children over 3 years of age with heart disease, 29% had not received routine dental care within the past year compared with 23.4% in the controls (P = NS). The parents of children with heart disease were found to pay less money out-of-pocket for their child's health care than the parents of control children (P less than 0.0001). The data suggest that important aspects of primary health care were neglected in a large group of children with heart disease and that cost was not a major cause for the inadequate preventive care delivery. An educational program directed at health care professionals and parents is proposed.