For children who are healthy, visits to the doctor's office for annual exams and vaccinations are associated with an increased risk of flu-like illness in the children and their family members within two weeks of the visit. These so-called "well-child" visits translate into more than 700,000 potentially avoidable illnesses a year, which cost in excess of $490 million per year, according to a new study.
"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. 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," said Dr. Phil Polgreen, lead author of the study, which was published in Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
Researchers from the University of Iowa used data to examine healthcare trends for 84,595 families that were collected from 1996 through 2008. This includes demographic, office-based, emergency and outpatient case records. After controlling for factors such as the presence of other children, insurance and demographics, the author found that well children under the age of six years old who visited the doctor increased the probability of flu-like illnesses in themselves and their families by 3.2 percent.
"This incremental risk could amount to more than 700,000 avoidable cases of flu-like illness each year and $492 million in direct and indirect costs, based on established estimates for outpatient influenza," writes the press release announcing the findings.
In a commentary accompanying the study, Dr. Lisa Saiman, a New York-based pediatrician, noted, "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."
The researchers suggest clinics follow recommended guidelines, including improved environmental cleaning, cough etiquette and hand hygiene compliance.
"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," said Polgreen.