Trends and characteristics of preventive care visits among commercially insured adolescents, 2003-2010

J Pediatr. 2014 Mar;164(3):625-30. doi: 10.1016/j.jpeds.2013.10.042. Epub 2013 Nov 25.


Objective: To examine preventive care visit patterns among commercially insured adolescents during 2003-2010. In 2005-2007, the Advisory Committee on Immunization Practices (ACIP) recommended 3 vaccines targeted at adolescents. We also investigate the relationship between preventive care visits and immunization.

Study design: Data were drawn from the MarketScan database. Adolescents aged 11-21 continuously enrolled in the same insurance plan during the calendar year were included. We calculated the annual proportion of adolescents with at least 1 preventive and 1 vaccination-related visit. Longitudinal analyses were conducted by following the 1992 birth cohort for 8 consecutive years.

Results: The proportion of adolescents making at least 1 preventive visit increased from 24.6%-41.1% during 2003-2010. The rate of vaccination-related visits increased from 12.9%-26.3%. The magnitude of the increase in preventive and vaccination-related visits was greater during the years in which ACIP issued recommendations. The rates of preventive and vaccination-related visits were considerably higher among female and early adolescents and adolescents in managed care plans. Longitudinal analyses indicated that only 2.4% of adolescents had an annual preventive visit during the 8 years.

Conclusions: Yearly improvements in preventive care visits by adolescents were substantial. ACIP recommendations may be associated with this improvement. However, ongoing efforts are needed to improve the use and delivery of preventive care services.

MeSH terms

  • Adolescent
  • Age Distribution
  • Child
  • Databases, Factual
  • Female
  • Humans
  • Male
  • Managed Care Programs
  • Office Visits / statistics & numerical data
  • Office Visits / trends*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Practice Guidelines as Topic
  • Preventive Health Services / statistics & numerical data*
  • Sex Distribution
  • United States / epidemiology
  • Vaccination / statistics & numerical data
  • Vaccination / trends*
  • Young Adult