NEW ORLEANS — Older parents and those with private insurance were more likely to miss well child visits, according to a study in a family practice clinic that treats both parents and children, Dwenda Gjerdingen, M.D., said at the annual conference of the Society of Teachers of Family Medicine.
Children younger than 18 years comprise one-fifth of all visits to primary care physicians. Well child visits are the sixth most common reason for seeing a family physician, and the No. 1 reason for seeing a pediatrician.
“Despite their importance, many well child visits are missed,” said Dr. Gjerdingen, professor in the department of family medicine and community health at the University of Minnesota, Minneapolis.
Dr. Gjerdingen and her associates conducted a telephone survey of parents at the university's Bethesda Clinic in St. Paul who missed an appointment between January and December 2002. Respondents were 90% female, 61% married, and 50% employed. Fifty-seven percent were insured through public assistance. Mean age of parents was 26 years and mean age of children was 5.4 months. Parents were 65% Southeast Asian, 15% African American, 14% white, and 6% other. Almost half (48%) had less than a 12th-grade education; 86% kept well child visits. Among the 14% who were noncompliant, “I forgot” was the No. 1 reason cited. Most parents, 77%, said they like telephone reminders.
All respondents said they believed well child visits are important, citing vaccinations as the No. 1 reason. Therefore, Dr. Gjerdingen said, “We can use that for encouraging parents to come to visits.”
A minority of parents, 20%, said they were “often” or “always” stressed. Financial or employment concerns were most often cited.
Contrary to other compliance studies, younger parents were more likely to keep visits, Dr. Gjerdingen found. “I was surprised by age, that the older they were the more likely they were to miss the appointment,” she said.
Another unexpected finding was parents with private insurance were more likely to miss appointments compared with those who had public insurance. “I was wondering if it was a copay differential,” she said.
Small sample size and single center setting were limitations of the study.