Comparison of Home and Clinic Well-Baby Visits in a Military Population

Abstract

Patient satisfaction is an indicator of quality of care received. Home-visit programs are associated with increased satisfaction and equivalent clinical outcomes but increased cost, compared with clinic visits. We hypothesized that home visits for routine well-child care would also be associated with increased satisfaction and equivalent outcomes. One thousand infants born at Tripler Army Medical Center were identified, and 630 were enrolled. Army and Air Force dependents received 2-week clinic visits. Navy and Marine Corps dependents were offered home visits. At 4 to 6 weeks, families completed a questionnaire. Maternal satisfaction and quality of anticipatory guidance were higher in the home-visit group. Clinical outcomes were equal. Home visits for routine well-child care are valid and are associated with greater maternal satisfaction, better anticipatory guidance, and equivalent clinical outcomes.

Well-Child Care Clinical Practice Redesign for Young Children: A Systematic Review of Strategies and Tools

“…Eleven articles were identified through a reference search of accepted articles. Thirty-three articles were accepted; these included 13 articles primarily on alternative formats for WCC, 16,25-36 2 articles primarily on nonclinical locations for WCC, 37,38 17 articles primarily on nonphysicians/ non-NPs added to enhance WCC, 17,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] and 1 miscellaneous article. 55 Of 13 WCC format articles, 5 were on non-face-to-face formats, [25][26][27][28]36 and 8 were on group visit formats.…”

“…Christ et al 37 conducted a controlled trial of home WCC among military families for the 2-week well-child visit. Home visits lasted 60 to 90 minutes, were provided by an NP, and included all typical WCC services.…”

Managing the first period at home with a newborn: a grounded theory study of mothers’ experiences

“…Further, providing sufficient information efficiently from the hospital to well‐baby clinics should not be a problem in an electronic world, enabling PHN to offer a home visit the first days at home to inform and comfort the parents. Home visits contribute to building relationships and normalizing the new situation, and especially common problems with breastfeeding and taking care of the baby are reported earlier (44–47).…”