Change in Site of Children's Primary Care: A Longitudinal Population-Based Analysis

Evidence that fewer children are being seen at family physician (FP) practices has not been confirmed using population-level data. This study examines the proportion of children seen at FP and pediatrician practices over time and the influence of patient demographics and rurality on this trend. We c...

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Bibliographic Details
Published in:Annals of family medicine 2019-09, Vol.17 (5), p.390-395
Main Authors: Wasserman, Richard C, Varni, Susan E, Hollander, Matthew C, Harder, Valerie S
Format: Article
Language:English
Subjects:
Child health services
Demographic aspects
Forecasts and trends
Original Research
Primary health care
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Summary:Evidence that fewer children are being seen at family physician (FP) practices has not been confirmed using population-level data. This study examines the proportion of children seen at FP and pediatrician practices over time and the influence of patient demographics and rurality on this trend. We conducted a retrospective longitudinal analysis of Vermont all-payer claims (2009-2016) for children aged 0 to 21 years. The sample included 184,794 children with 2 or more claims over 8 years. Generalized estimating equations modeled the outcome of child attribution to a FP practice annually, with covariates for calendar year, child age, sex, insurance, and child Rural Urban Commuting Area (RUCA) category. Over time, controlling for other covariates, children were 5% less likely to be attributed to a FP practice (
ISSN:1544-1709
1544-1717
DOI:10.1370/afm.2416