HEALTH CARE FOR U.S. KIDS GETS A D-

Posted by: Cathy Arnst on October 12, 2007

I wrote a story this week about a disturbing study in the latest issue of The New England Journal of Medicine—children in the U.S. get recommended health-care procedures only 46% of the time when they see a doctor. We’re talking middle- and upper-middle-class, white, children with private health insurance. Minority, poor and uninsured kids almost certainly get even worse care.

In fact, conventional wisdom to the contrary, kids in America get worse care than adults—even t hough the grown-ups only get recommended procedures 53% of the time, according to an similar study done four years ago. Even the researchers who did this latest study were stunned:

“As a pediatrician, I was shocked by some of our findings,” said lead researcher Rita Mangione-Smith of Seattle Children’s Hospital Research Institute.
“I rescreened several of the charts because I couldn’t believe the results we were getting.”

The research team, from the Rand Corp. and University of Washington as well as Seattle Children’s, reviewed the medical records of 1,536 children from 12 metropolitan areas around the country and assessed 175 measures of quality in 12 clinical areas. They discovered that children receive recommended preventive care such as routine screenings only 41% of the time; 53% of the recommended care for chronic medical conditions such as asthma and diabetes and 68% of recommended care for acute medical problems such as respiratory and gastric illnesses.

Some of the more startling discoveries:

• Sixty-nine percent of 3- to 6-year-olds did not have their height and weight measured at annual checkups, and only 15% of adolescents were weighed and measured, even though one-third of American children are overweight or obese.

• Fifty-four percent of children diagnosed with asthma did not get recommended treatment.

• Sixty-two percent of children were not screened for anemia in the first two years of life, although the test is recommended for all babies.

• Only 38% of children received the proper care for acute diarrhea, one of the main causes of hospitalizations in children under age 5.

The researchers blamed these care deficits in part on the fact that insurers pressure doctors to see as many patients in as short a time as possible, so the pediatricians just don’t have time to do all that they should do. The message here: parents should go to each and every checkup and doctor visit armed with a list of questions and requests for recommended tests. Visit the American Academy of Pediatricians to learn the recommended treatments for virtually every childhood disease, including features on how to communicate with your pediatrician. Click here for a vaccine scheduling chart from the Centers for Disease Control and Prevention. Sad to say, you just can’t trust the doctor to know what’s best.

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