Prevalence and correlates of high-quality basic pediatric preventive care

Area of Science:

• Pediatric Health Services Research
• Quality of Care Assessment
• Preventive Medicine

Background:

• The scope of recommended pediatric preventive services has expanded significantly.
• Understanding clinician and system factors influencing the delivery of basic preventive services (BPS) is crucial.

Purpose of the Study:

• To assess the quality of basic pediatric preventive services (excluding immunizations) using parent-reported data.
• To identify sociodemographic, health system, and service correlates of BPS provision.

Main Methods:

• Cross-sectional analysis of 2041 children aged 4-35 months from the 2000 National Survey of Early Childhood Health.
• The Basic Preventive Services (BPS) scale measured receipt of developmental assessment, injury prevention counseling, parental smoking screening, and guidance on reading and other topics.
• BPS quality was categorized as excellent, good, fair, or poor.

Main Results:

• Most children received good (31.5%) or excellent (34.9%) care, while 33.6% received fair or poor care.
• No significant associations were found between BPS levels and race/ethnicity, insurance status, or practice setting.
• Higher BPS scores correlated with longer well-child visits, increased counseling, reduced delayed care, and higher parental satisfaction.

Conclusions:

• Approximately two-thirds of children receive good or excellent basic preventive care.
• The equitable distribution of high-quality care, irrespective of socioeconomic factors, suggests strong clinician professionalism.
• Visit duration and the BPS scale show promise for monitoring and improving national pediatric preventive care quality.