Practice guidelines can help to improve the quality of treatment provided, although they are not always followed. This study aimed to see if a 2007 American Academy of Pediatrics recommendation to stop routine screening urinalysis in children affected the results. Researchers used a difference-in-differences approach to estimate visit-level screening urinalysis proportions before (2005-2006, n=1,247) and after (2008-2009, n=1,772) the 2007 AAP recommendation, using data from the National Ambulatory Medical Care Survey. They compared children aged 4 to 18 too young people aged 19 to 32. Analyses were stratified by patient gender and visit setting and adjusted for continuous patient age, race/ethnicity, physician specialization, and patient gender.
The 2007 guideline was linked to no significant change in adjusted visit-level screening urinalysis proportions in child visits (20.4% to 22.5%), but a rise in young adult visits (20.1 % to 27.0%) – a differential impact of -4.8% percentage point difference (95% CI -9.0, -0.5). In private clinics, female children’s visit proportions declined by 7.6 percentage points (95% CI -13.7, -1.5), whereas male children’s visit proportions decreased by 0.5 percentage points (95% CI -10.6, 9.6). Female children’s visit proportions declined by 17.4 percentage points (95% CI -27.9, -6.8) in community health centers, while male children’s visit proportions decreased by 33.5 percentage points (95% CI -47.4, -19.7). A 2007 recommendation to stop routine screening urinalysis on children was linked to no change in kid visits but an increase. Nearly a quarter of all child visits still included a urinalysis screening.
Reference:bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-14-260
