Pediatricians and Parents Key to Improving Quality of Children's Health Care

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Pediatricians and Parents Key to Improving Quality of Children's Health Care

http://www.newswise.com/articles/view/502773/?sc=wire

Improving the quality of children’s health care will require continued

commitment by the nation’s pediatricians and parents to demand effective

as well as affordable pediatric care from legislators, insurers and

providers of care, said Simpson, MB, BCH*, MPH, a University of

South Florida pediatrician who holds the All Children’s Hospital Guild

Endowed Chair in Child Health Policy.

“While pediatricians have been forceful advocates for better insurance

coverage for children, they’ve been less active in the policy debate

over quality of care. Their voices need be stronger at both the state

and national levels,” said Dr. Simpson, a USF professor of pediatrics

and chief of the Division of Child Health Outcomes. “At the same time,

parents need to be given clearly understandable information about

quality indicators so they can make informed choices about health plans

and medical care for their children on the basis of quality and cost.”

Dr. Simpson is the co-author of a report titled “Measuring the Quality

of Children’s Healthcare: A Prerequisite to Action” published this month

as a supplement to the journal Pediatrics. The paper’s other author is

Dougherty, PhD, senior child health advisor at the Agency for

Healthcare Research and Quality, the lead federal agency for research on

the quality and safety of health care.

The article prioritizes recommendations to move forward the national

agenda for improving the quality of children’s health care. The

recommendations were developed by a group of 40 child health experts,

advocates and purchasers of health care who met in Washington, DC. The

top recommendation was to create an information technology system,

designed with children’s unique needs in mind, that would help

physicians and other practitioners more efficiently track health care

indicators like patient satisfaction, emergency room visits, pain levels

and treatment outcomes.

“Systems that work for children’s health care and quality would not

necessarily be a natural byproduct of mainstream information technology

systems,” the authors write. “For example, current computerized

physician order-entry systems typically are not designed to include

weight- and body-mass measurements, an essential part of preventing

medication errors in children’s health care.”

The authors report that investing in the research and information

technology needed to evaluate and improve children’s health often takes

a back seat to reducing the rising costs of health care – an issue

re-emerging as a political hot button. Yet the two are inextricably

linked, Dr. Simpson said. “Poor quality health care in childhood can

lead to greater consumption of health services and lost productivity in

adulthood. For example, failure to prevent, diagnose and treat obesity

in childhood could set a person up for a higher lifetime risk of

cardiovascular disease and other chronic illnesses.”

Even when convincing evidence demonstrates that a medical practice

results in better outcomes, practitioners often fall short of providing

optimal care for children, Dr. Simpson said. For example, despite clear

evidence and guidelines for primary care of childhood asthma, less than

60 percent of pediatric patients receive the inhaled steroidal

medications most effective in controlling the disease, she said. “Yet,

experts agree that most emergency room visits and hospitalizations for

asthma attacks could be avoided if more children were taking the right

medications.”

Dr. Simpson said pediatricians are critical to closing the gap between

what is known about children’s health (evidence-based practice) and what

is often practiced. They can commit to improvement in their own

practices and join in national research collaboratives such as the

Pediatric Research in Office Settings (PROS) network sponsored by the

American Academy of Pediatrics, she said. Pediatricians enrolled in PROS

work with AAP researchers to design studies, obtain research funding,

and collect and report shared findings.

“Across Florida, only 30 practices participate in PROS,” Dr. Simpson

said. “This is a great start, but we need even more good research by

pediatricians at the practice level to provide the basis for new quality

measures and to build public support for quality-improvement efforts.”

* Dr. Simpson earned her medical degree in Ireland hence the different

abbreviations. She received her pediatric training in the United States

and is a licensed physician.