Table 2.
Comparisons of Pediatric Routine Care Between Children Who Utilize the Same Versus Different Primary Care Clinic as Their Linked Parent in the OCHIN Network, 2010 to 2018.
| Parent and child clinic concordance | Unadjusted rate | RR (95% CI) | aRR (95% CI) |
|---|---|---|---|
| Outcome 1. Well-child checks first 15 months of life a (N = 11 547 parents; 14 040 children) | |||
| Different clinic group | 4.3 | Ref | Ref |
| Same clinic group | 4.6 | 1.07 (1.02, 1.12) | 1.06 (1.02, 1.10) |
| Outcome 2. Well-child checks ages 3-17 years, yearly a (N = 36 531 parents; 56 474 children) | |||
| Different clinic group | 0.58 | Ref | Ref |
| Same clinic group | 0.60 | 1.02 (0.99, 1.06) | 1.02 (0.98, 1.06) |
| Unadjusted prevalence | OR (95% CI) | aOR (95% CI) | |
| Outcome 3. Vaccinations completed, among children under age 2 years (Combination 7) b (N = 12 465 parents; 15 296 children) | |||
| Different clinic group | 47.6% | Ref | Ref |
| Same clinic group | 51.8% | 1.18 (1.08, 1.30) | 1.12 (1.03, 1.21) |
| Vaccinations completed, among adolescents up to age 18 years c (N = 21 559 parents; 29 681 children) | |||
| Different clinic group | 33.1% | Ref | Ref |
| Same clinic group | 31.1% | 0.91 (0.85, 0.98) | 0.88 (0.81, 0.95) |
Abbreviation: aOR, adjusted odds ratio; aRR, adjusted rate ratio; CI, confidence interval; HPV, human papillomavirus vaccine; MCV, meningococcal vaccine; OR, odds ratio; RR, rate ratio Ref, referent group.
Some parents are linked to more than one child; children are linked to a single parent in the dataset.
Estimates derived using generalized estimating equations logistic (odds) or Poisson (rate) regression and robust sandwich variance estimation for clustering within child’s primary clinic. Adjusted for parent’s preferred language, income, total children, influenza vaccination, preventive care use, number of chronic conditions, and child’s age at first encounter, race & ethnicity, insurance, number of chronic conditions, and U.S. region. Additionally, estimates were adjusted for child’s total visits in the 3 years and older outcomes. P-value <.05 in bold.
Well-child checks were identified through the combination of provider type (MD, DO, NP, PA) and CPT codes (99381-99387, 99391-99397, G0438, G0439).
Combination 7 vaccination (number required) for children prior to age 2 years: Diphtheria, Tetanus, acellular Pertussis (4); Polio (3); Measles, Mumps, Rubella (1); Haemophilus influenza type b (3); Hepatitis B (3); Varicella; Pneumococcal; Hepatitis A (1); and Rotavirus (≥2).1,14
Adolescent vaccines completed prior to age 18 years: Human papillomavirus (2) and Meningococcal (1) vaccinations.