Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-01T02:14:42.008Z Has data issue: false hasContentIssue false
  • English
  • Français

Are Well-Child Visits a Risk Factor for Subsequent Influenza-Like Illness Visits?

Published online by Cambridge University Press:  10 May 2016

Jacob E. Simmering ,
Linnea A. Polgreen ,
Joseph E. Cavanaugh  and
Philip M. Polgreen
Jacob E. Simmering
Affiliation:
Department of Pharmacy Practice and Science, University of Iowa, Iowa City, Iowa
Linnea A. Polgreen
Affiliation:
Department of Pharmacy Practice and Science, University of Iowa, Iowa City, Iowa
Joseph E. Cavanaugh
Affiliation:
Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa
Philip M. Polgreen*
Affiliation:
Departments of Internal Medicine and Epidemiology, University of Iowa, Iowa City, Iowa
*
Division of Infectious Diseases, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA 52242 (philip-polgreen@uiowa.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

To determine whether well-child visits are a risk factor for subsequent influenza-like illness (ILI) visits within a child's family. DESIGN. Retrospective cohort.

Methods.

Using data from the Medical Expenditure Panel Survey from the years 1996-2008, we identified 84,595 families. For each family, we determined those weeks in which a well-child visit or an ILI visit occurred. We identified 23,776 well-child-visit weeks and 97,250 ILI-visit weeks. We fitted a logistic regression model, where the binary dependent variable indicated an ILI clinic visit in a particular week. Independent variables included binary indicators to denote a well-child visit in the concurrent week or one of the previous 2 weeks, the occurrence of the ILI visit during the influenza season, and the presence of children in the family in each of the age groups 0–3, 4–7, and 8–17 years. Socioeconomic variables were also included. We also estimated the overall cost of well-child-exam-related ILI using data from 2008.

Results.

We found that an ILI office visit by a family member was positively associated with a well-child visit in the same or one of the previous 2 weeks (odds ratio, 1.54). This additional risk translates to potentially 778,974 excess cases of ILI per year in the United States, with a cost of $500 million annually.

Conclusions.

Our results should encourage ambulatory clinics to strictly enforce infection control recommendations. In addition, clinics could consider time-shifting of well-child visits so as not to coincide with the peak of the influenza season.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 3 , March 2014 , pp. 251 - 256
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2014

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Bright Futures/American Academy of Pediatrics. Recommendations for Preventive Pediatric Health Care (Periodicity Schedule). http://www.aap.org/en-us/professional-resources/practice-support/financing-and-payment/Documents/Recommendations_Preventive_Pediatric_Health_Care.pdf. Accessed April 9, 2012.Google Scholar
2. Schappert, SM, Burt, CW. Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 2001-02. Vital Health Stat 2006;13:1–66.Google Scholar
3. American Academy of Pediatrics Committee on Infectious Diseases. Infection prevention and control in pediatric ambulatory settings. Pediatrics 2007;120:650–665.Google Scholar
4. Posfay-Barbe, KM, Zerr, DM, Pittet, D. Infection control in paediatrics. Lancet Infect Dis 2008;8:19–31.Google Scholar
5. Canadian Paediatric Society. Infection control in paediatric office settings. Position paper 2008-03. Paediatr Child Health 2008; 13:408–435.Google Scholar
6. Turnberg, W, Danieli, W, Seixas, N, et al. Appraisal of recommended respiratory infection control practices in primary care and emergency department settings. Am J Infect Control 2008; 36:268–275.Google Scholar
7. Medical Expenditure Panel Survey. US Department of Health and Human Services Agency for Healthcare Research and Quality website, http://meps.ahrq.gov/mepsweb/. Accessed April 9, 2012.Google Scholar
8. Marsden-Haug, N, Foster, VB, Gould, PL, Elbert, E, Wang, H, Pavlin, JA. Code-based syndromic surveillance for influenza-like illness by International Classification of Diseases, Ninth Revision. Emerg Infect Dis 2007;13:207–216.Google Scholar
9. Cohen, D, Coco, A. Trends in well-child visits to family physicians by children younger than 2 years of age. Ann Fam Med 2010; 8:245–248.Google Scholar
10. Molinari, NA, Ortega-Sanchez, IR, Messonnier, ML, et al. The annual impact of seasonal influenza in the US: measuring disease burden and costs. Vaccine 2007;25:5086–5096.CrossRefGoogle ScholarPubMed
11. Herwaldt, LA, Smith, SD, Carter, CD. Infection control in the outpatient setting. Infect Control Hosp Epidemiol 1998;19:41–74.Google Scholar
12. Goodman, RA, Solomon, SL. Transmission of infectious diseases in outpatient health care settings. JAMA 1991;265:2377–2381.Google Scholar
13. Askew, GL, Finelli, L, Hutton, M, et al. Mycobacterium tuberculosh transmission from a pediatrician to patients. Pediatrics 1997; 100:19–23.Google Scholar
14. Moore, M, Schulte, J, Valway, SE, et al. Evaluation of transmission of Mycobacterium tuberculosis in a pediatric setting. J Pediatr 1998;133:108–112.Google Scholar
15. Lobovits, AM, Freeman, J, Goldmann, DA, Mcintosh, K. Risk of illness after exposure to a pediatric office. N Engl J Med 1985; 313:425–428.CrossRefGoogle ScholarPubMed
16. Quach, C, Moore, D, Ducharme, F, Chalut, D. Do pediatric emergency departments pose a risk of infection? BMC Pediatr 2011; 11:2.Google Scholar
17. Quach, C, McArthur, M, McGeer, A, et al. Risk of infection following a visit to the emergency department: a cohort study. CMAJ 2012;184:E232–E239.Google Scholar