Pediatric Practice Redesign with Group Well Child Care Visits: A Multi-Site Study

Area of Science:

• Pediatrics
• Health Services Research
• Community Health

Background:

• Barriers to efficient well-child care disproportionately affect low-income, immigrant communities.
• Group well-child care models show potential for improving care delivery and health outcomes.
• Practice redesign is crucial for enhancing healthcare services in underserved populations.

Purpose of the Study:

• To assess the feasibility of group well-child care in urban academic practices serving immigrant children.
• To evaluate health outcomes and process measures of group well-child care versus traditional care.
• To compare screening rates, guidance retention, and patient satisfaction between the two care models.

Main Methods:

• Prospective intervention control study design.
• Recruitment for group well-child care or traditional visits during the first year of life.
• Culturally sensitive curriculum based on American Academy of Pediatrics (AAP) guidelines; analysis via surveys and medical records.

Main Results:

• Group care enrolled 101 families; traditional care enrolled 74.
• Higher rates of postpartum depression and domestic violence screening in group care (65% vs 37%; 38% vs 17%).
• Improved anticipatory guidance retention (67% vs 37%) and higher patient satisfaction in group care, with no increase in clinic time.

Conclusions:

• Group well-child care is a feasible practice redesign for low-income, immigrant families.
• This model increases psychosocial screening and anticipatory guidance delivery and retention.
• Parental satisfaction is higher with group care, offering more provider face time without extending practice duration.