February 13, 2014
Well-Child Doctor Visits Lead To Higher Risk Of Illness: Study
Brett Smith for redOrbit.com - Your Universe Online
A new study from researchers at the University of Iowa presents parents with an interesting dilemma – bringing a healthy child in for a check-up or vaccination might be the right thing to do for their health, but it could expose them to a higher risk of illness.
According to the study, which was published in the journal Infection Control and Hospital Epidemiology, “well child” visits to the doctor could be causing more than 700,000 potentially avoidable flu-like illnesses each year.
"Well child visits are critically important. However, our results demonstrate that healthcare professionals should devote more attention to reducing the risk of spreading infections in waiting rooms and clinics," said Dr. Phil Polgreen, an epidemiologist at the University of Iowa. “Infection control guidelines currently exist. To increase patient safety in outpatient settings, more attention should be paid to these guidelines by healthcare professionals, patients, and their families.”
In the study, the researchers used data culled from the Agency for Healthcare Research and Quality's (AHRQ) Medical Expenditure Panel Survey from 1996 to 2008 to look at the healthcare trends of nearly 85,000 families. Included in the evaluation were demographic, office-based, hospital, and outpatient case records. After controlling for confounding factors, such as demographics, the authors learned that well-child visits for patients younger than six years old boosted the odds of a flu-like illness in these children or their families during the following two weeks by 3.2 percent.
The study authors conclude that the more than 700,000 avoidable cases of illness each year result in over $490 million in direct and indirect costs.
In an editorial published alongside the study, Dr. Lisa Saiman, a pediatrician from Columbia University Medical Center, wrote that "the true cost of flu-like illnesses are much higher since only a fraction result in ambulatory visits and many more cases are likely to result in missed work or school days.”
“Furthermore, these flu-like illness visits are associated with inappropriate antimicrobial use,” she added.
The authors noted that their study emphasized the importance of infection reduction and management. They suggested that relevant healthcare facilities follow infection mitigation guidelines, which include maintaining cleaning regimens, practicing proper cough etiquette, and following hand hygiene rules.
Sailman wrote that there may be some resistance among healthcare staff to changing routines or recognizing bad habits.
“One can imagine the complexity of implementing infection prevention and control practices to prevent (flu-like illness) in a pediatric primary care setting, and numerous barriers exist to do so,” she wrote. “These include knowledge, attitude, and practice barriers.”
“Attitude barriers experienced by staff may include disagreement with the recommendations, lack of confidence that infection prevention and control practices can be implemented in the ambulatory care setting, lack of belief that the practices may improve their patients’ outcomes, and the inertia of current practice,” she continued. “Practice barriers may be particularly relevant for ambulatory settings and include lack of time, space, money, administrative support, and/or ancillary personnel.”
Polgreen noted that infections can easily spread if all proper steps are not taken.
"Even with interventions, such as the restricted use of communal toys or separate sick and well-child waiting areas, if hand-hygiene compliance is poor, and potentially infectious patients are not wearing masks, preventable infections will continue to occur,” he said.