September 1, 2002
Christina Bethell, Neal Halfon, Melinda K. Abrams, et al.
Partnering with Parents to Promote the Healthy Development of Young Children Enrolled in Medicaid, Christina Bethell, Colleen Peck, Melinda Abrams, et al., The Commonwealth Fund, September 2002
A new survey of families with young Medicaid-insured children has found that while two of five parents have concerns about their infant or toddler's social, behavioral, or cognitive development, only about one of five said their child receives the full range of preventive and developmental services recommended by experts in pediatric care. According to the Commonwealth Fund report, Partnering with Parents to Promote the Healthy Development of Young Children Enrolled in Medicaid, these findings confirm the need for continued efforts to bridge the gap between pediatric care guidelines and physician practice.
The Promoting Healthy Development Survey-PLUS, administered by FACCT, Inc. (the Foundation for Accountability) in North Carolina, Vermont, and Washington, asked approximately 6,000 mothers of Medicaid-enrolled children under age 4 whether their pediatrician talks to them about ""anticipatory"" guidance topics such as feeding and nutrition, sleeping, nurturing, injury prevention, communication, discipline, and language development. The survey was also used to determine whether health plans and providers offer follow-up counseling for parents whose children may be at risk for developmental problems, and whether they assess the family's home lifeincluding parents' mental health, alcohol and drug use, violence, and emotional and economic supports.
The Commonwealth Fund commissioned the study in the three states to obtain information on the status of health promotion and developmental services for Medicaid children. Along with Utah, these states are participating in the Fund's Assuring Better Child Health and Development (ABCD) program to help state Medicaid agencies improve their capacity to furnish preventive and developmental services.
The authors said that state Medicaid agencies need to implement policies to monitor and improve the quality of pediatric care. Pediatricians, meanwhile, should seek opportunities to learn about parents' concerns and assess children's development and well-being.Facts and Figures
- Forty percent of parents reported at least one concern about their child's social, emotional, behavioral, and/or cognitive development. Moreover, the concerns of approximately one of five (19%) parents were significant enough to indicate that their child was at moderate to high risk for developmental delay.
- Two of five parents reported that their child's pediatric clinician did not routinely ask them whether they had concerns about their child's development and well-being. Less than half (46%) of parents with potentially serious concerns about their child said they received the information they needed to address those concerns.
- Children who had a regular, personal pediatric clinician or nurse were one-and-a-half times more likely to receive a basic level of comprehensive care than children without one (24% vs. 16%). Nevertheless, nearly one of five children lacked a personal pediatric provider (17%).