0
May 1, 1991, Vol 265, No. 17 >
ARTICLE | May 1, 1991

Health Care Use Among Young Children in Day Care: Title and subTitle BreakResults in a Randomized Trial of Early Intervention FREE

Marie C. McCormick, MD, ScD; Jeanne Brooks-Gunn, PhD; Sam Shapiro; April A. Benasich, PhD; George Black; Ruth T. Gross, MD
[+] Author Affiliations

A preliminary version of this report was presented at the American Pediatric Society—Society for Pediatric Research—Ambulatory Pediatric Association meetings, May 8,1990, Anaheim, Calif, and published in abstract form in Pediatric Research (1990;27:249).

Reprint requests to Joint Program in Neonatology, The Children's Hospital, 300 Longwood Ave, Boston, MA 02115 (Dr McCormick).


JAMA. 1991;265(17):2212-2217. doi:10.1001/jama.1991.03460170066035
Text Size: A A A
Published online
Article
References

Exposure of young children to group day-care settings increases the risk of illness and may result in higher use of medical care. These observations raise concerns that the use of such settings for early intervention programs for low—birth-weight infants may increase the already high burden of medical care costs incurred by these children and their families. To address the question of medical care use associated with center-based care, we examined the hospital-based and ambulatory care reported for participants of the Infant Health and Development Program. This project is a multisite randomized trial of an early intervention program for preterm low—birth-weight infants with an intervention including 2 years of center-based care. The Intervention group did not differ in hospital-based care and averaged only two more physicians' visits over the 3-year observation period than the comparison group. We conclude that early intervention programs involving high-quality group care are not accompanied by substantial increases in health care use.

(JAMA. 1991;265:2212-2217)

REFERENCES

1 +
Darlington RB, Royce JM, Snipper AS, Murray HW, Lazar I.  Preschool programs and later school competence of children from low-income families . Science. 1980;;208:202-204.
2 +
Olds DL.  Can home visitation improve the health of women and children at risk ? In: Ginzburg E, Rogers DE, eds. Improving the Chances of Children at Risk . Boulder, Colo: Westview Press; 1990;:79-103.
3 +
Brooks-Gunn J.  Promoting health development in young children: what educational interventions work ? In: Ginzburg E, Rogers DE, eds. Improving the Chances of Children at Risk . Boulder, Colo: Westview Press; 1990;:125-145.
4 +
 The Infant Health and Development Program. Enhancing the outcomes of low—birth-weight, premature infants: a multisite, randomized trial . JAMA. 1990;;263:3035-3042.
5 +
Haskins R, Kotch J.  Day care and illness: evidence, costs and public policy . Pediatrics. 1986;; 77:951-982.
6 +
Osterholm MT, Klein JO, Aronson SS, Pickering LK, eds.  Infectious disease in child day care: management and prevention . Rev Infect Dis. 1986;;8:513-679.
7 +
Berkelman RL, Tacker SB.  What is the health impact of day care attendance on infants and preschoolers ? Public Health Rep. 1989;;104:101-103.
8 +
Bell DM, Gleiber DW, Mercer AH, et al.  Illness associated with child day care: a study of incidence and cost . Am J Public Health. 1989;;79:479-484.
9 +
Anderson LJ, Parker RA, Strikas RA, et al.  Day-care center attendance and hospitalization for lower respiratory tract illness . Pediatrics. 1988;; 82:300-308.
10 +
McCormick MC.  The contribution of low birth weight to infant mortality and childhood morbidity . NEngl J Med. 1985;;312:82-90.
11 +
Hack M, Blanche C, Rivers A, Fanaroff AA.  The very low birth weight infant: the broader spectrum of morbidity during infancy and childhood . J Dev Behav Pediatr. 1983;;4:243-249.
12 +
Bowman E, Yu VYH.  Continuing morbidity in extremely low birthweight infants . Early Hum Dev. . 1989;;18:165-174.
13 +
McCormick MC, Shapiro S, Starfield BH.  Rehospitalization in the first year of life for high-risk survivors . Pediatrics. 1980;;66:991-999.
14 +
Hack M, DeMonterice D, Merkatz IR, Jones P, Fanaroff AA.  Rehospitalization of the very-low— birth-weight infant: a continuum of perinatal and environmental morbidity . AJDC. 1981;;135: 263-266.
15 +
Shankaran S, Cohen SN, Linver M, Zonia S.  Medical care costs of high-risk infants after neonatal intensive care: a controlled study . Pediatrics. 1988;;81:372-378.
16 +
McCormick MC, Bernbaum JC, Eisenberg JM, Kustra SL, Finnegan E.  Costs incurred by parents of very low birth weight infants after the initial neonatal hospitalization . Pediatrics . In press.
17 +
Elander G, Nilsson A, Lindberg T.  Behavior in four-year-olds who have experienced hospitalization and day care . Am J Orthopsychiatry. 1986;; 56:612-616.
18 +
DeGraw C, Edell D, Ellers B.  Public Law 99-457: new opportunities to serve young people with special needs . J Pediatr. 1988;;113:971-974.
19 +
Newacheck PW, Halfon N.  Access to ambulatory care services for economically disadvantaged children . Pediatrics. 1986;;78:813-819.
20 +
Egbuonu L, Starfield B.  Child health status and social status . Pediatrics. 1982;;69:550-557.
21 +
Zigler E, Nuenchow S.  Infectious diseases in day care: parallels between psychologically and physically healthy care . Rev Infect Dis. 1986;;8: 514-520.
22 +
Baydar N, Paikoff RL, Brooks-Gunn J.  Effects of child-care arrangements on cognitive and behavioral outcomes in 3 and 4 year olds: evidence from the children of the NLSY . Dev Psychol. In press.
23 +
Efron B.  Forcing a sequential experiment to be balanced . Biometrika. 1971;;58:403-417.
24 +
Pocock SJ, Simon R.  Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial . Biometrics. 1975;; 31:103-115.
25 +
Kraemer HS, Fendt K.  Random assignment in clinical trials: issues in planning . J Clin Epidemiol . In press.
26 +
Hurwitz ES, Gunn WJ, Pensky PF, Schonberger CB.  Risk of respiratory illness associated with day-care attendance: a nationwide study . Pediatrics . 1991;;87:62-69.
27 +
Berg AT, Shapiro ED, Capobianci LA.  Group day care and the risk of serious infectious illnesses . Am J Epidemiol. 1991;;133:154-163.
28 +
Sparling J, Lewis I, Neuwirth S. Early Partners . Lewisville, NC: Kaplan Press. In press.
29 +
Sparling J, Lewis I. Partners for Learning. Lewisville, NC: Kaplan Press; 1984;.
30 +
Wasik BH, Bryant DM, Lyons C. Home Visiting. Newbury Park, Calif: Sage Publications. In press.
31 +
Wasik BH. Coping With Parenting Through Effective Problem Solving: A Handbook for Professionals . Chapel Hill, NC: Frank Porter Graham Child Development Center; 1984;.
32 +
Ramey CT, Bryant DM, Wasik BH, Sparling JJ, Fendt KH, LaVange LM.  The Infant Health and Development Program for low birthweight, premature infants: program elements, family participation, and child intelligence . Pediatrics. In press.
33 +
Hayes CD, Palmer JL, Zaslow MJ. Who Cares for America's Children ? Washington, DC: National Academy Press; 1990;.
34 +
National Center for Health Statistics. Current Estimates From the National Health Interview Survey: United States, 1981 . Hyattsville, Md: Dept of Health and Human Services; 1982;. Vital and Health Statistics Series 10, No. 141; DHHS publication (PHS)83-1569.
35 +
Shapiro S, McCormick MC, Starfield BH, Krischer JR, Bross D.  Relevance of correlates of infant mortality for morbidity at 1 year . Am J Obstet Gynecol. 1980;;136:363-373.
36 +
Baker PC, Mott FL. NLSY Child Handbook— 1989: A Guide and Resource Document for the National Longitudinal Survey of Youth 1986 Child Health Data . Columbus, Ohio: Center for Human Resource Research, Ohio State University; 1989;.
37 +
Scott DT, Bauer CR, Kraemer HC, Tyson J.  A neonatal health index for qi preterm infants . Pediatr Res. 1989;;25:263. Abstract.
38 +
Fleiss JL.  Analysis of data from multiclinic trials . Controlled Clin Trials. 1986;;7:267-275.
39 +
SAS User's Guide: Statistics . Version 5 edition. Cary, NC: SAS Institute; 1985;.
40 +
Starfield B, Van den Berg BJ, Steinwachs DM, Katz HP, Horn SD.  Variations in utilization of health services for children . Pediatrics. 1979;; 63:633-641.
41 +
Kramer MS, Arsenault L, Pless IB.  The use of preventable adverse outcomes to study the quality of child health care: a new application of case-control research . Med Care. 1984;;22:223-230.
42 +
Brooks-Gunn J, McCormick MC, Shapiro S, Benasich AA, Black G.  Maternal education, employment and fertility: results seen in a randomized trial of early intervention . Presented at the International Conference on Infant Studies; April 20, 1990; Montreal, Quebec.
43 +
Andersen R, Newman JF.  Societal and individual determinants of medical care utilization in the United States . Milbank Memorial Fund Q. 1973;; 51:95-124.
44 +
Cafferata GL, Kasper JS.  Family structure and children's use of ambulatory physician services . Med Care. 1985;;23:250-260.
45 +
Horwitz SM, Morgenstern H, Beckman LF.  The impact of social stressors and social networks on pediatric medical care use . Med Care. 1985;;23:946-959.
46 +
Wolfe BL.  Children's utilization of medical care . Med Care. 1980;;18:1196-1207.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Darlington RB, Royce JM, Snipper AS, Murray HW, Lazar I.  Preschool programs and later school competence of children from low-income families . Science. 1980;;208:202-204.
2 +
Olds DL.  Can home visitation improve the health of women and children at risk ? In: Ginzburg E, Rogers DE, eds. Improving the Chances of Children at Risk . Boulder, Colo: Westview Press; 1990;:79-103.
3 +
Brooks-Gunn J.  Promoting health development in young children: what educational interventions work ? In: Ginzburg E, Rogers DE, eds. Improving the Chances of Children at Risk . Boulder, Colo: Westview Press; 1990;:125-145.
4 +
 The Infant Health and Development Program. Enhancing the outcomes of low—birth-weight, premature infants: a multisite, randomized trial . JAMA. 1990;;263:3035-3042.
5 +
Haskins R, Kotch J.  Day care and illness: evidence, costs and public policy . Pediatrics. 1986;; 77:951-982.
6 +
Osterholm MT, Klein JO, Aronson SS, Pickering LK, eds.  Infectious disease in child day care: management and prevention . Rev Infect Dis. 1986;;8:513-679.
7 +
Berkelman RL, Tacker SB.  What is the health impact of day care attendance on infants and preschoolers ? Public Health Rep. 1989;;104:101-103.
8 +
Bell DM, Gleiber DW, Mercer AH, et al.  Illness associated with child day care: a study of incidence and cost . Am J Public Health. 1989;;79:479-484.
9 +
Anderson LJ, Parker RA, Strikas RA, et al.  Day-care center attendance and hospitalization for lower respiratory tract illness . Pediatrics. 1988;; 82:300-308.
10 +
McCormick MC.  The contribution of low birth weight to infant mortality and childhood morbidity . NEngl J Med. 1985;;312:82-90.
11 +
Hack M, Blanche C, Rivers A, Fanaroff AA.  The very low birth weight infant: the broader spectrum of morbidity during infancy and childhood . J Dev Behav Pediatr. 1983;;4:243-249.
12 +
Bowman E, Yu VYH.  Continuing morbidity in extremely low birthweight infants . Early Hum Dev. . 1989;;18:165-174.
13 +
McCormick MC, Shapiro S, Starfield BH.  Rehospitalization in the first year of life for high-risk survivors . Pediatrics. 1980;;66:991-999.
14 +
Hack M, DeMonterice D, Merkatz IR, Jones P, Fanaroff AA.  Rehospitalization of the very-low— birth-weight infant: a continuum of perinatal and environmental morbidity . AJDC. 1981;;135: 263-266.
15 +
Shankaran S, Cohen SN, Linver M, Zonia S.  Medical care costs of high-risk infants after neonatal intensive care: a controlled study . Pediatrics. 1988;;81:372-378.
16 +
McCormick MC, Bernbaum JC, Eisenberg JM, Kustra SL, Finnegan E.  Costs incurred by parents of very low birth weight infants after the initial neonatal hospitalization . Pediatrics . In press.
17 +
Elander G, Nilsson A, Lindberg T.  Behavior in four-year-olds who have experienced hospitalization and day care . Am J Orthopsychiatry. 1986;; 56:612-616.
18 +
DeGraw C, Edell D, Ellers B.  Public Law 99-457: new opportunities to serve young people with special needs . J Pediatr. 1988;;113:971-974.
19 +
Newacheck PW, Halfon N.  Access to ambulatory care services for economically disadvantaged children . Pediatrics. 1986;;78:813-819.
20 +
Egbuonu L, Starfield B.  Child health status and social status . Pediatrics. 1982;;69:550-557.
21 +
Zigler E, Nuenchow S.  Infectious diseases in day care: parallels between psychologically and physically healthy care . Rev Infect Dis. 1986;;8: 514-520.
22 +
Baydar N, Paikoff RL, Brooks-Gunn J.  Effects of child-care arrangements on cognitive and behavioral outcomes in 3 and 4 year olds: evidence from the children of the NLSY . Dev Psychol. In press.
23 +
Efron B.  Forcing a sequential experiment to be balanced . Biometrika. 1971;;58:403-417.
24 +
Pocock SJ, Simon R.  Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial . Biometrics. 1975;; 31:103-115.
25 +
Kraemer HS, Fendt K.  Random assignment in clinical trials: issues in planning . J Clin Epidemiol . In press.
26 +
Hurwitz ES, Gunn WJ, Pensky PF, Schonberger CB.  Risk of respiratory illness associated with day-care attendance: a nationwide study . Pediatrics . 1991;;87:62-69.
27 +
Berg AT, Shapiro ED, Capobianci LA.  Group day care and the risk of serious infectious illnesses . Am J Epidemiol. 1991;;133:154-163.
28 +
Sparling J, Lewis I, Neuwirth S. Early Partners . Lewisville, NC: Kaplan Press. In press.
29 +
Sparling J, Lewis I. Partners for Learning. Lewisville, NC: Kaplan Press; 1984;.
30 +
Wasik BH, Bryant DM, Lyons C. Home Visiting. Newbury Park, Calif: Sage Publications. In press.
31 +
Wasik BH. Coping With Parenting Through Effective Problem Solving: A Handbook for Professionals . Chapel Hill, NC: Frank Porter Graham Child Development Center; 1984;.
32 +
Ramey CT, Bryant DM, Wasik BH, Sparling JJ, Fendt KH, LaVange LM.  The Infant Health and Development Program for low birthweight, premature infants: program elements, family participation, and child intelligence . Pediatrics. In press.
33 +
Hayes CD, Palmer JL, Zaslow MJ. Who Cares for America's Children ? Washington, DC: National Academy Press; 1990;.
34 +
National Center for Health Statistics. Current Estimates From the National Health Interview Survey: United States, 1981 . Hyattsville, Md: Dept of Health and Human Services; 1982;. Vital and Health Statistics Series 10, No. 141; DHHS publication (PHS)83-1569.
35 +
Shapiro S, McCormick MC, Starfield BH, Krischer JR, Bross D.  Relevance of correlates of infant mortality for morbidity at 1 year . Am J Obstet Gynecol. 1980;;136:363-373.
36 +
Baker PC, Mott FL. NLSY Child Handbook— 1989: A Guide and Resource Document for the National Longitudinal Survey of Youth 1986 Child Health Data . Columbus, Ohio: Center for Human Resource Research, Ohio State University; 1989;.
37 +
Scott DT, Bauer CR, Kraemer HC, Tyson J.  A neonatal health index for qi preterm infants . Pediatr Res. 1989;;25:263. Abstract.
38 +
Fleiss JL.  Analysis of data from multiclinic trials . Controlled Clin Trials. 1986;;7:267-275.
39 +
SAS User's Guide: Statistics . Version 5 edition. Cary, NC: SAS Institute; 1985;.
40 +
Starfield B, Van den Berg BJ, Steinwachs DM, Katz HP, Horn SD.  Variations in utilization of health services for children . Pediatrics. 1979;; 63:633-641.
41 +
Kramer MS, Arsenault L, Pless IB.  The use of preventable adverse outcomes to study the quality of child health care: a new application of case-control research . Med Care. 1984;;22:223-230.
42 +
Brooks-Gunn J, McCormick MC, Shapiro S, Benasich AA, Black G.  Maternal education, employment and fertility: results seen in a randomized trial of early intervention . Presented at the International Conference on Infant Studies; April 20, 1990; Montreal, Quebec.
43 +
Andersen R, Newman JF.  Societal and individual determinants of medical care utilization in the United States . Milbank Memorial Fund Q. 1973;; 51:95-124.
44 +
Cafferata GL, Kasper JS.  Family structure and children's use of ambulatory physician services . Med Care. 1985;;23:250-260.
45 +
Horwitz SM, Morgenstern H, Beckman LF.  The impact of social stressors and social networks on pediatric medical care use . Med Care. 1985;;23:946-959.
46 +
Wolfe BL.  Children's utilization of medical care . Med Care. 1980;;18:1196-1207.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems