Influences on the receipt of well-child visits in the first two years of life

To determine demographic and health care system factors associated with children receiving an adequate number of well-child visits (WCVs). Information on 4385 children and their families was obtained via birth certificates, parent interviews, chart review of outpatient sites of care, and insurance records. Only 77% of children received at least five WCVs by age 2. In regression analysis, the factors most strongly associated with children's total number of WCVs were delay in the initiation of prenatal care (odds ratio = 0.6) and receipt of all outpatient care in private physician offices (odds ratio = 4.2 to 5.6). Having an adequate number of WCVs was associated with being up to date for immunizations. Children of mothers who delay prenatal care are at high risk for not receiving adequate numbers of WCVs. Recognition of this marker can allow for targeted interventions that aim to ensure that children receive appropriate preventive care.