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Kids who miss more than half of their recommended well-child visits are twice as likely to end up in hospital compared to those who attend most of their visits, a new study suggests.

The latest research published in the American Journal of Managed Care involved more than 20,000 children. 

Furthermore, researchers found that children with chronic conditions like asthma and heart disease who missed more than half their recommended well-child visits were three times more likely to be hospitalized compared to children with chronic conditions who attend most of the visits.

"Well-child visits are important because this is where children receive preventive immunizations and develop a relationship with their provider," lead author Jeffrey Tom, MD, MS, an assistant investigator with the Kaiser Permanente Center for Health Research in Hawaii, said in a news release. "These visits allow providers to identify health problems early and help to manage those problems so the children are less likely to end up in the hospital."

"Regular preventive care for children with special needs and chronic conditions is even more important, given the risk of possible complications for their conditions, often leading to hospitalizations," coauthor David C. Grossman, MD, MPH, a senior investigator at Group Health Research Institute in Seattle added.

Researchers looked at data from 20,065 children who were enrolled in Group Health from 1999 to 2006.  The children were followed from birth until age 3.5 years or until their first hospital stay.

During the study, the children were recommended to attend nine well-child visits between birth and 3.5 years.  The visits start at three to five days and continue at 1, 2, 4, 6, 10, and 15 months, and at 2 and 3.5 years.

There was a pretty good adherence rate among study participants. Researchers found that 76 percent of the children in the study attended at least three-quarters of the recommended visits.  The researchers noted that Group Health required no copayment, and that the lack of copayment may have been a reason for such good adherence to visits among the participants.

In total, 4 percent of the children in the study and 9 percent of children with chronic conditions were hospitalized.

Researchers found that those who had missed more than half their visits had 1.4 to 2.0 times the risk of hospitalization compared to those who attended most of their visits.

Children with chronic conditions who had missed more than half their visits were 1.9 to 3.2 times more likely to be hospitalized compared to those who attended most of their visits.

However, researchers noted that the findings might not apply to all health systems.  Participants in the latest study were part of an integrated health care system where the majority of children attend most of the well-child visits.  The children in the study also came from families with higher-than-average income and education.

While the study does not prove causation, it does show a strong link between missing well-child visits and higher chance of hospitalization.

Researchers explain that one reason for this association could be that well-child visits allow for preventative care that keeps children from going to the hospital. Another reason could be that parents who miss well-child visits are also less likely to properly manage their children's illness and end up following treatment regimens that result in higher rates of hospitalization for the children.