Quality of Preventive Health Care for Young Children: Strategies for Improvement

Policymakers increasingly understand the importance of children’s early years for promoting health, learning, and school readiness and for identifying and mediating risk that can compromise later functioning. Yet not all parents receive the services needed to identify developmental and behavioral issues in early childhood. In the National Survey of Early Childhood Health, conducted in 2000, only 57 percent of parents reported their child’s development ever being assessed within a pediatric visit. While most parents receive counseling on traditional topics like immunization and nutrition, up to one-third report they did not receive counseling on important developmental and behavioral topics like discipline and toilet training. In a separate survey, pediatricians cited time constraints and inadequate reimbursement as barriers to providing optimal developmental services. To improve the quality of early childhood health care, the authors recommend national standards, enhanced reimbursement, improved provider training, and a strategy of raising parents’ expectations of pediatric care. Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and should not be attributed to The Commonwealth Fund or its directors, officers, or staff. Additional copies of this and other Commonwealth Fund publications are available online at www.cwmf.org. To learn more about new Fund publications when they appear, visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 822.