Alice Kuo, Moira Inkelas, Molly Maidenberg, M.S.W., M.P.H., Debra S. Lotstein, M.D., M.P.H., Kyra M. Samson, M.D., M.P.H., and Neal Halfon, M.D., M.P.H.
A. A. Kuo, M. Inkelas, M. Maidenberg et al., "Pediatricians' Roles in the Provision of Developmental Services: An International Study," Journal of Developmental and Behavioral Pediatrics, Aug. 2009, 30(4):331–39.
A 10-nation study examines how the provision of pediatric developmental services is apportioned among different types of health care providers— pediatricians, general practice physicians, and nurses. In doing so, the researchers shed light on the uniquely broad role that U.S. pediatricians play in delivering child health care.
In the United States, pediatricians are primarily responsible for all child health services—acute care, developmental monitoring, health supervision, referral, and care coordination. But many other industrialized nations divide responsibility among health care professionals, with pediatricians focusing on providing specialized developmental care for children with identified problems, as well as managing chronic conditions. In some cases, a national maternal and child health care infrastructure also carries some of the burden. To improve outcomes in the U.S., we face a choice between building more support around the pediatrician-focused medical home model and dividing responsibility for services among providers, say the authors.
The study team performed structured interviews with 20 child health care experts in 10 countries: Australia, Canada, Denmark, England, France, Germany, Japan, the Netherlands, Spain, and Sweden. Participants were asked to respond to four scenarios representing common diagnostic and treatment issues in pediatric developmental health.
Involving nurses, general practitioners, and other clinicians in the delivery of developmental services might enable children in the United States to receive more thorough and effective care.