U.S. Kids Not Getting Needed Health Care(nd screening Smith said. Prevention is...),Health

Why are these deficits happening?

Partly because of the structure of the health-care system, which pressures physicians to see as many patients as possible in a short period of time, Smith suggested. "In a lot of cases, the annual check-up gets a 10-minute slot on a doctor's schedule," she said. "How can we accomplish all we are supposed to do and give parents time to voice their concerns?"

Physicians also need to be trained better in preventive care. Right now, the emphasis is on dealing with acute illness.

Parents, too, have a role to play. "Parents need to be quite proactive with their child's health care," Smith said.

And perhaps a checklist for doctors might improve matters.

"We're human, just like airplane pilots are human, and having that tool would go a long way to solving this problem," Smith said.

But much of the solution lies with policymakers.

"Our study shows that health-care quality is an issue in and of itself apart from the access problem, which is an equally important but separate problem," Smith said. "People who are promoting better access to care for children through the SCHIP bill recognize this needs to go hand in hand with efforts to assess and improve quality of care."

More information

For more on this issue, visit the National Initiative for Children's Healthcare Quality.

SOURCES: Oct. 10, 2007, teleconference with Elizabeth A. McGlynn, Ph.D., associate director, Rand Health, and Rita Mangione-Smith, M.D., researcher, Seattle Children's Hospital Research Institute, and associate professor, pediatrics, University of Washington School of Medicine, Seattle; Lisa Simpson, M.B., director, Child Policy Research
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