The Impact of Infant Well-Child Care Compliance and Social Risks on Emergency Department Utilization

Abstract

Deployment of medical and social services at well-child visits promotes child health. A retrospective review of the electronic health record was conducted for infants presenting for their "newborn" visit over a 2-year period at an urban, academic primary care center. Primary outcomes were time to first emergency department (ED) visit, number of ED visits (emergent or nonemergent), and number of nonemergent ED visits by 2 years of life. Records from 212 consecutive newborns were evaluated-59.9% were black/African American and 84.4% publicly insured. A total of 72.6% visited the ED by 2 years of life. Sixty percent received ≥5 well-child visits by 14 months; 25.9% reported ≥1 social risk. There were no statistically significant associations between number of completed well-child visits, or reported social risks, and ED utilization. Renewed focus on preventive care delivery and content and its effect on ED utilization, and other patient outcomes, is warranted.

Clinician Experiences and Attitudes Regarding Screening for Social Determinants of Health in a Large Integrated Health System

“…Social needs put patients at higher risk for poor health outcomes, 6,7,8 and are a source of frustration and suffering for patients that complicate care delivery. 9,10 Thus, social needs may serve as actionable indicators of adverse social determinants of health. Implementation of uniform social needs screening tools is increasing, especially as programs become better able to address social needs through referrals to social needs services.…”

Associations of adverse social determinants of health with missed well-child visits and the role of caregiver social support

“…Alternatively, among patients experiencing adverse SDH, social support has been shown to enhance medical adherence among adults and caregiver social support has been implicated in improved management of chronic childhood disease management, such as asthma [17,18]. However, few, if any, studies have examined the relationship between adverse SDH, including various domains of material hardship, on missed preventive care visits and the in luence of social support in the pediatric setting [19].…”