Skip to content
My WebMD Sign In, Sign Up

Children's Health

Font Size

Health Guidelines for Kids Are Skipped

Study Shows Children May Not Always Get Up-to-Date Treatment
By
WebMD Health News
Reviewed by Louise Chang, MD

Oct. 10, 2007 -- Less than half of the outpatient medical care delivered to American children is in line with recommendations for the best treatment, concludes a study released Wednesday.

The results, which researchers called "shocking," show that 47% of the care delivered to children in doctors' offices and clinics meets professional recommendations or is up to date scientifically.

The study -- conducted among 1,536 children in 12 cities -- comes four years after similar research showing American adults receive recommended care 55% of the time.

"No one anywhere is immune to the risk of poor-quality care," says Elizabeth A. McGlynn, PhD, a researcher at RAND Corp. who worked on the study.

Two-thirds of children being treated for acute illnesses received appropriate care, the researchers found after reviewing medical records.

But proper care for chronic conditions like asthma and diabetes was delivered just half the time, while 41% of the children received recommended preventive care, the study showed.

Researchers guessed that the results may actually underestimate the problem because the study participants were primarily white and from wealthier families.

"I want to emphasize that the results of this study are the best-case scenario," says researcher Rita Mangione-Smith, MD, MPH.

Mangione-Smith told reporters that just 31% of 3-year-old children in the study received routine height and weight measurements at the pediatrician's office. "As a pediatrician I was shocked by some of our findings," she said. "I even rescreened some of the charts because I couldn't believe some of the results we were getting."

Busy Doctors

The researchers in part blame doctors' overly tight schedules, which often allow for 10-minute doctor visits that can crowd out needed care. They also say pediatrician residency training tends to focus on treating serious illnesses in the hospital, and not enough on prevention.

Joseph Hagan, MD, a co-author of soon-to-be released practice guidelines from the American Academy of Pediatrics, says he disagrees with some of the study's methods. But he also calls the conclusion that children receive recommended care less than half the time "abysmal."

"I see this report as a little bit of a face slap, but we know there's been a problem and this helps us get a sense of how to go and fix it," says Hagan, a pediatrician in private practice in Burlington, Vt.

Hagan acknowledges that many pediatricians do not keep up to date on the latest recommendations and findings. But he also blames insurance company policies that pay doctors primarily for treating diseases and not for patient education or disease screenings.

Researchers suggest that parents not rely on doctors to remember every point of recommended screenings. Mangione-Smith urges parents to take a checklist culled from the American Academy of Pediatrics web site or other sources to the doctor's office.

"Parents do need to be quite proactive about their child's health care," Mangione-Smith says.

(Do you feel your child has good health care? Why or why not? Talk with others on WebMD's Parenting: Preschoolers and Grade Schoolers message board.)

Today on WebMD

child with red rash on cheeks
What’s that rash?
plate of fruit and veggies
How healthy is your child’s diet?
 
smiling baby
Treating diarrhea, fever and more.
Middle school band practice
Understanding your child’s changing body.
 

worried kid
fitArticle
boy on father's shoulder
Article
 
Child with red rash on cheeks
Slideshow
girl thinking
Article
 

Loaded with tips to help you avoid food allergy triggers.

Loading ...

Sending your email...

This feature is temporarily unavailable. Please try again later.

Thanks!

Now check your email account on your mobile phone to download your new app.

babyapp
New
Child with adhd
Slideshow
 
rl with friends
fitSlideshow
Syringes and graph illustration
Tool