As Washington debates children’s health insurance, a startling study finds that kids who regularly see doctors get the right care less than half the time – whether it’s preschool shots or chlamydia tests for teen girls.
The findings, from the first comprehensive look at children’s health care quality, are particularly troubling because nearly all the 1,536 children in the nationwide study had insurance.
Eight-two percent were covered by private insurance. Three- quarters were white, and all lived in or near large or midsize cities.
Two experts called the findings “shocking.” Others said minority children – those with more-restrictive government insurance and the millions with no insurance at all – certainly fare even worse.
They said the results highlight the importance of the debate over the proposed expansion of the State Children’s Health Insurance Program, which Congress approved and President Bush vetoed. A vote to override the veto is set for next week.
The study, by the Seattle Children’s Hospital Research Institute and the nonprofit Rand Corp. research group, concludes that overall, doctors gave children the appropriate outpatient medical care only 47 percent of the time.
“They got an ‘F’,” said Dr. Joseph F. Hagan, a Burlington, Vt., pediatrician. Hagan co-edited the American Academy of Pediatrics’ latest update to its children’s health guidelines, due out later this month.
“It’s sad, but I think it reflects some unpleasant realities about our current health care system or, I might say, non-system,” he said.
The compliance rate was even worse than that found in a study of adults: The kids got only 55 percent of recommended care.
The new research found that children’s doctors did best in providing the recommended care for acute medical problems – 68 percent. They scored just 53 percent for treating chronic conditions and 41 percent for preventive care.
The study, based on a review of two years of medical records of children in 12 metropolitan areas (none in Colorado), was reported in today’s edition of the New England Journal of Medicine.
Dr. Rita Mangione-Smith, lead investigator at the Seattle institute and an associate professor at the University of Washington, and other experts said they hope the new findings lead to action.
Hagan said doctors can do more to keep up with the latest care guidelines. But he said they can’t solve all the problems, such as insurance plans that don’t cover crucial screenings and the inadequate time pediatricians have to spend with each child.
