Randomised controlled trial of effect of Baby Check on use of health services in first 6 months of life

BMJ 1999;318:1740-1744 ( 26 June )

General Practice

Randomised controlled trial of effect of Baby Check on use of health services in first 6 months of life

Editorial by Jewell

Hilary Thomson, research fellow, ^a Sue Ross, lecturer in health service research, ^a Philip Wilson, senior research fellow, ^a Alex McConnachie, statistician, ^a Richard Watson, general practitioner. ^b

^a Department of General Practice, University of Glasgow, Woodside Health Centre, Glasgow, G20 7LR, ^b Craigallian Surgery, 11 Craigallian Avenue, Glasgow G72 8RW

Correspondence to: H Thomson, Department of Community Health Sciences, General Practice Primary Care Research Group, University of Edinburgh, Edinburgh EH8 9DX Hilary.Thomson{at}ed.ac.uk

Objective: To evaluate the effect of Baby Check, an illnessscoring system for babies of 6 months or less, on parents' useof health services for theirbaby.
Design: Randomised controlledtrial.
Setting: 13 general practices inGlasgow.
Subjects: 997 newly delivered mothers, randomised toreceive either Baby Check and Play It Safe, an accident preventionleaflet (n=497), or Play It Safe alone (control group, n=500).
Main outcome measures: Data on consultations and referrals extractedfrom general practice notes after 6months.
Results: At the time of recruitment, maternal characteristicswere similar for both groups (mean maternal age 29 years; deprivationcategories 6 and 1 in both groups; 424 (45%) mothers were primiparous).At 6 months, general practice notes were available for 467 (94%)of the Baby Check group and 468 (94%) of the control group. Thenumber of general practitioner consultations did not differ betweenthe groups: median number of consultations was 2 (interquartilerange 1 to 4) in the Baby Check group, and 2 (1 to 3) in the controlgroup. Use of out of hours services did not differ significantlybetween the two groups (86 v 85; P=0.93).
Conclusion: Distributing Baby Check to an unselected groupof mothers does not affect use of health services for infantsup to 6 months ofage.

Key messages

Baby Check is an illness scoring system designed to help parents assess the seriousness of acute illness in infants aged 0-6 months
In our study population Baby Check had little effect on recognition and response to illness as measured by use of health services
A third of babies in both groups received at least one prescription for antibiotics in the first 6 months of life
Introducing Baby Check introduced as a routine part of child health care without further endorsement would not alter demand for health services

© BMJ 1999

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Rapid Responses:

Read all Rapid Responses

Prescribing of antibiotics to babies: P Selley, et al.
bmj.com, 25 Aug 1999 [Full text]
Baby Check encourages appropriate use of health services: T J Cole, et al.
bmj.com, 17 Dec 1999 [Full text]