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

The Article in Brief

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

Richard C. Wasserman , and colleagues

Background 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.

What This Study Found A Vermont study suggests that a declining proportion of children receive care in family medicine practices. These same children, particularly those in isolated rural areas, are more likely to visit pediatric practices. Using statewide all-payer claims data from 2009-2016, the study looked at 184,794 children with at least two claims in that period. The data revealed that a child�s odds of attending a family practice vs. a pediatric practice declined by an average of 5% each year during the study period. Reasons for this trend may include the national decline in family physicians providing prenatal care and lack of capacity for new patients in family medicine practices. The study also showed that the likelihood of attending a family medicine practice went up with increased child age, if the patient was female, or if the patient was enrolled in Medicaid.

Implications

• The declining proportion of children attending FP practices, especially in very rural areas, represents a continuing challenge for the specialty of family medicine.