Does continuity between prenatal and well-child care improve childhood immunizations?

Abstract

BACKGROUND AND OBJECTIVES: Continuity of care has been associated with positive health benefits, but the benefit of continuity for the maternal-child unit has not been studied. This study determined whether continuity from prenatal to pediatric care is associated with higher immunization rates for low-income children in Delaware. METHODS: This retrospective cohort study included 187 women who received prenatal care in one of four clinics (predominantly family practice) over a 2-year period. Each maternal-child pair was defined as having provider continuity (same provider for prenatal and pediatric care), clinic continuity (same clinic but different provider), or no continuity (different clinic). We measured the association between continuity and completion of immunizations by 7 months of age and by 12 months of age. RESULTS: Provider continuity was significantly associated with a higher immunization rate both at 7 and 12 months of age. After controlling for age, gender, ethnicity, insurance, birth order, and language, this association persisted at 7 months but lost statistical significance at 12 months. Those with clinic continuity were not significantly different than those with no continuity for any outcomes. CONCLUSIONS: For low-income persons in Delaware, provider continuity for the maternal-child unit is associated with higher completion rates for early childhood immunizations.

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