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Right Care for Children: Top Five Do's and Don'ts

Matthew Schefft1, Alan R Schroeder2, Diane Liu3

  • 1Virginia Commonwealth University School of Medicine, Richmond, VA, USA.

American Family Physician
|March 16, 2019
PubMed

Insights

Low-value care in pediatrics includes both underuse and overuse of medical interventions. The Lown Institute

Area of Science:

  • Pediatric Healthcare Quality
  • Health Services Research
  • Clinical Practice Guidelines

Background:

  • Low-value care encompasses underuse, overuse, and ineffective interventions, leading to suboptimal patient outcomes and increased healthcare costs.
  • Identifying and addressing low-value care is crucial for improving the overall quality and efficiency of healthcare delivery.

Purpose of the Study:

  • To identify key areas of underuse and overuse in pediatric healthcare.
  • To provide actionable recommendations for promoting "Right Care" in children's health.

Main Methods:

  • The Lown Institute's Right Care Alliance Children's Health Council convened to identify "do" (underuse) and "don't" (overuse) recommendations.
  • Recommendations were based on expert consensus and aimed at improving healthcare value in pediatrics.

Main Results:

  • Five "do" recommendations focus on increasing access to beneficial interventions: long-acting reversible contraception for adolescents, nonpharmacologic ADHD treatment, shared decision-making for complex conditions, childhood literacy promotion, and socioeconomic status screening.
  • Five "don't" recommendations aim to reduce overuse: avoiding routine antibiotics for middle ear infections, head CTs for minor head trauma, albuterol for bronchiolitis, routine hyperlipidemia screening, and routine preparticipation sports evaluations.

Conclusions:

  • These ten recommendations provide concrete examples to guide clinicians in reducing low-value care and optimizing pediatric healthcare.
  • Implementing these "do" and "don't" guidelines can lead to improved patient outcomes and more efficient use of healthcare resources.

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