Wednesday, October 10, 2007
In the largest study of its kind, researchers found that America's children received appropriate medical care only 46 percent of the time when they visit health professionals, faring even worse than adults and raising serious questions about the quality of care delivered by the world's most expensive health system.
The study, to be published in the Oct. 11 issue of the New England Journal of Medicine, was conducted by the RAND Corp., the Seattle Children's Hospital Research Institute and the University of Washington School of Medicine.
It followed the health care experiences of 1,536 children from 12 metropolitan areas over a four-year period. By interviewing the youngsters' parents, reviewing the children's medical records and comparing their treatments to established care standards, researchers found that even basic care was a hit-or-miss proposition for children who visit hospitals and pediatricians.
The study found only 19 percent of seriously ill infants with fevers had the right lab tests done, only 44 percent of youngsters with asthma were on the right medications and only 38 percent of youngsters were screened for anemia in their first two years of life.
In addition, only 31 percent of children ages 3-6 have their weight measured at annual checkups.
Failure to provide proper care makes it harder to reverse illnesses and increases the chance that youngsters will carry health problems into adulthood. "How do we catch a child at risk for obesity if we don't look," said co-author Dr. Rita Mangione-Smith, an associate professor of pediatrics at the University of Washington School of Medicine.
The results are surprising, not least because most of the youngsters in the study were white, middle-class and had health insurance. "These are the kids who most people assume are getting excellent care in this country, and unfortunately they're not," Mangione-Smith said.
Ironically, the study's dearth of low-income and ethnically diverse youngsters likely skewed the final data, resulting in an "overly rosy" picture, Mangione-Smith said.
The entire McClatchy piece provides a good overview of the study printed in the NEJM (free full text article available).