Duration of a well-child visit: association with content, family-centeredness, and satisfaction

Neal Halfon; Gregory D Stevens; Kandyce Larson; Lynn M Olson

doi:10.1542/peds.2011-0586

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Duration of a well-child visit: association with content, family-centeredness, and satisfaction

Journal article

Peer reviewed

Duration of a well-child visit: association with content, family-centeredness, and satisfaction

Neal Halfon, Gregory D Stevens, Kandyce Larson and Lynn M Olson

Pediatrics (Evanston), Vol.128(4), pp.657-664

10/2011

DOI: 10.1542/peds.2011-0586

PMID: 21930541

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Abstract

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. 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. 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). 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. 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.

Adult

Child, Preschool

Cross-Sectional Studies

Female

Humans

Infant

Male

Patient Satisfaction - statistics & numerical data

Patient-Centered Care - statistics & numerical data

Pediatrics

Physical Examination - standards

Physical Examination - statistics & numerical data

Preventive Health Services - standards

Preventive Health Services - statistics & numerical data

Primary Health Care - standards

Primary Health Care - statistics & numerical data

Time Factors

United States

Details

Title: Subtitle: Duration of a well-child visit: association with content, family-centeredness, and satisfaction
Creators: Neal Halfon - Department of Public Policy, School of Public Affairs, University of California, Los Angeles, California;
Gregory D Stevens - University of Southern California
Kandyce Larson - Oklahoma State University Center for Health Sciences
Lynn M Olson - American Academy of Pediatrics
Resource Type: Journal article
Publication Details: Pediatrics (Evanston), Vol.128(4), pp.657-664
DOI: 10.1542/peds.2011-0586
PMID: 21930541
NLM abbreviation: Pediatrics
ISSN: 0031-4005
eISSN: 1098-4275
Publisher: American Academy of Pediatrics
Language: English
Date published: 10/2011
Academic Unit: Public Policy Center (Archive)
Record Identifier: 9984283855802771

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114 Times Cited - Web of Science