Objectives: 

This study aimed to describe the prevalence of medically diagnosed audiologic, developmental, ophthalmologic, and neurologic conditions in a foster care primary care clinic and to identify any associations among these diagnoses and patient characteristics, placement type, and maltreatment type.

Methods: 

This study used the electronic medical records for patients (n = 4977), aged 0 to 20 years, with at least 1 visit to an academic-affiliated medical center primary care clinic exclusively serving children in foster care between January 1, 2017, and December 31, 2020. This study was a retrospective chart review. Descriptive statistics were calculated. Bivariate logistic regression analysis was used to determine associations between the outcome variables and each independent variable. Multivariable logistic regression analysis was performed using only significant independent variables from the bivariate analysis.

Results: 

Overall, 3.5% of children had an audiologic diagnosis, 42% had a developmental diagnosis, 9.0% had an ophthalmologic diagnosis, and 4.5% had a neurologic diagnosis. There were increased odds of developmental delay with child neglect and medical complexity and decreased odds with Hispanic ethnicity, Black race, female sex, obesity, and shelter placement.

Conclusion: 

These findings add to the limited data regarding medically diagnosed audiologic, developmental, ophthalmologic, and neurologic conditions for children in foster care in a primary care setting. A medical home may help children in foster care, who experience many barriers to comprehensive health care, to better identify and address these health conditions. Future studies are needed that examine health outcomes of children in foster care with these health conditions followed in a medical home.

中文翻译：

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寄养儿童初级保健诊所的听力学、发育学、眼科和神经学诊断的描述

目标： 

本研究旨在描述寄养初级保健诊所中医学诊断的听力、发育、眼科和神经系统疾病的患病率，并确定这些诊断与患者特征、安置类型和虐待类型之间的关联。

方法： 

本研究使用了患者 (n = 4977) 的电子病历，患者年龄为 0 至 20 岁，在 2017 年 1 月 1 日至 12 月期间至少访问过专门为寄养儿童提供服务的学术附属医疗中心初级保健诊所 1 次2020 年 3 月 31 日。这项研究是一项回顾性图表审查。计算描述性统计数据。使用双变量逻辑回归分析来确定结果变量与每个自变量之间的关联。仅使用双变量分析中的显着自变量进行多变量逻辑回归分析。

结果： 

总体而言，3.5% 的儿童有听力学诊断，42% 有发育学诊断，9.0% 有眼科诊断，4.5% 有神经学诊断。儿童忽视和医疗复杂性导致发育迟缓的几率增加，而西班牙裔、黑人种族、女性、肥胖和庇护所安置导致发育迟缓的几率降低。

结论： 

这些发现补充了有关初级保健机构寄养儿童医学诊断的听力学、发育、眼科和神经系统疾病的有限数据。医疗之家可以帮助寄养儿童更好地识别和解决这些健康状况，这些儿童在获得全面医疗保健方面遇到许多障碍。未来的研究需要检查寄养儿童的健康结果以及医疗之家跟踪的这些健康状况。