Most children excluded from daycare for illness seek acute medical care

1. In a survey assessing healthcare-seeking behavior, it was found that among parents with children unable to attend childcare due to illness, over 88% sought acute medical care.

2. Single/divorced parents, parents needing a doctor’s note, and African American parents were more likely to seek care for their child at an emergency department (ED) or urgent care (UC) center.

Evidence Rating Level: 2 (Good)      

Study Rundown: Eighty percent of children under the age of 6 in the United States require childcare, which places children at an increased risk for upper respiratory infections, ear infections, and diarrheal illness. Although the American Academy of Pediatrics (AAP) has published guidelines for management of illness in childcare settings, children are often excluded from childcare for mild illness. Their parents must then take time off of work to seek acute care, placing significant burden on working families, businesses, and the healthcare system. This study employed a nationally representative survey to evaluate healthcare-seeking behavior among parents with children excluded from childcare. 88% of parents sought urgent medical care for their child and a significant proportion sought care at the ED (25%) or UC (26%). ED/UC use was significantly higher among parents needing a note for their child to return to care, parents who were single or divorced, and African American parents. One limitation of this study is selection bias. Nonetheless, these findings suggest that parent and childcare provider education on AAP childcare illness guidelines may reduce the number of children unnecessarily excluded from childcare.

Click to read the study, published today in Pediatrics

Relevant Reading: Health Care Utilization and Expenditures Associated with Child Care Attendance

In-Depth [retrospective cohort study]: This study utilized the National Poll on Children’s Health from the C.S. Mott Children’s Hospital in Michigan to evaluate healthcare-seeking behavior among parents with a child excluded from childcare due to illness. The primary outcome of interest was seeking care at an ED or UC. 303 parents had at least one child requiring care outside the home and, among those parents, 88% reported taking their child to a medical provider when excluded from daycare due to illness. 26% sought care at a UC and 25% sought care at an ED. ED/UC use was combined for logistic regression analysis. Parents needing a note for their child to return to care were significantly more likely to use an ED/UC (aOR = 4.2, 95% CI: 1.5 – 11.7), as were single or divorced parents (aOR = 4.3; 95% CI: 1.4 – 13.5), and African American parents (aOR = 4.2; 95% CI: 1.2 – 14.6).

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