15- and 18-month, 4-year well-child visits most often missed

(HealthDay)—Well-child visits (WCVs) at 15 months, 18 months, and four years are the most commonly missed among children of low-income families, according to a study published online Oct. 10 in Pediatrics.

Elizabeth R. Wolf, M.D., M.P.H., from the Virginia Commonwealth University in Richmond, and colleagues retrospectively studied 152,418 children (aged 0 to 6 years) seen at two health networks in 20 states between 2011 and 2016. Adherence to the 13 American Academy of Pediatrics-recommended WCVs from birth to age 6 years was assessed.

The researchers found that most children were either publicly insured (77 percent) or uninsured (14 percent). The most frequently attended visits included the two-, four-, and six-month visits (63 percent with no outside care after the last recorded WCV and 90 percent with outside care). The least frequently attended were the 15- and 18-month visits (41 to 75 percent) and the four-year visit (19 to 49 percent). Patients who were publicly insured and uninsured had higher odds of missing WCVs versus privately insured patients. Hispanic and Asian-American patients had higher odds of attending WCVs versus non-Hispanic white patients.

"Across patients of different races and with different insurance types, WCVs at 15 months, 18 months, and at four years were the most commonly missed," the authors write. "Children who missed these visits may lack developmental screenings and other preventive services typically performed at these ages."