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Published on: September 19, 2019
Duration of a well-child visit: association with content, family-centeredness, and satisfaction
Neal Halfon1, Gregory D Stevens, Kandyce Larson
1Department of Pediatrics, UCLA Center for Healthier Children, Families, and Communities, David Geffen School of Medicine, Los Angeles, California 90024, USA. nhalfon@ucla.edu
Insights
Shorter pediatric well-child visits are linked to less preventive service content and lower parent satisfaction. Longer visits improve care quality and parent experience, highlighting the need to address time constraints in pediatric primary care.
Area of Science:
- Pediatric primary care
- Health services research
- Preventive medicine
Background:
- Pediatric primary care faces time limitations impacting recommended preventive service delivery.
- The fast-paced nature of pediatric practice necessitates monitoring visit length and its impact on care quality.
- Understanding visit duration's association with content, family-centered care, and parent satisfaction is crucial.
Purpose of the Study:
- To analyze the duration of well-child visits.
- To investigate the relationship between visit length and care content, family-centered care, and parent satisfaction.
- To examine these associations within a national sample of children.
Main Methods:
- Cross-sectional telephone survey of parents with children aged 4 to 35 months.
- Utilized data from the 2000 National Survey of Early Childhood Health (n=2068).
Main Results:
- One-third of parents reported visits lasting 10 minutes or less.
- Longer visits correlated with increased anticipatory guidance and psychosocial risk assessment.
- Visits exceeding 20 minutes showed higher odds of developmental assessment and parent satisfaction.
Conclusions:
- Many well-child visits are brief, negatively affecting care content, quality, and parent satisfaction.
- Strategies to enhance preventive services must consider the time allocated to well-child care.
- Study findings, based on parent reports from 2000, should be viewed alongside subsequent practice changes.
Background:
Studies of pediatric primary care suggest that time is an important limitation to the delivery of recommended preventive services. Given the increasingly frenetic pace of pediatric practice, there is an increased need to monitor the length of pediatric visits and the association of visit length with content, family-centered care, and parent satisfaction with care.
Objective:
To examine the length of well-child visits and the associations of visit length with content, family-centered care, and parent satisfaction among a national sample of children.
Methods:
We conducted a cross-sectional telephone survey of parents of children aged 4 to 35 months from the 2000 National Survey of Early Childhood Health (n = 2068).
Results:
One-third (33.6%) of parents reported spending ≤ 10 minutes with the clinician at their last well-child visit, nearly half (47.1%) spent 11 to 20 minutes, and 20.3% spent >20 minutes. Longer visits were associated with more anticipatory guidance, more psychosocial risk assessment, and higher family-centered care ratings. A visit of >20 minutes was associated with 2.4 (confidence interval [CI]: 1.5-3.7) higher odds of receiving a developmental assessment, 3.2 (CI: 1.7-6.1) higher odds of recommending the clinician, and 9.7 (CI: 3.5-26.5) higher odds of having enough time to ask questions.
Conclusions:
Many well-child visits are of short duration, and shorter visits are associated with reductions in content and quality of care and parent satisfaction with care. Efforts to improve preventive services will require strategies that address the time devoted to well-child care. The results of this study should be interpreted in light of changes in practice standards, reimbursement, and outcome measurement that have taken place since 2000 and the limitations of the measurement of utilization solely on the basis of parent report.
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