Children's Health

Good communication between doctors, parents, and children remains the cornerstone of high quality pediatric care

Good communication between doctors and parents and their children is an essential component of high-quality pediatric care. Fortunately, this is an area in which parents report few problems, according to a recently developed consumer survey. The Child Care Survey from the Consumer Assessment of Health Plans Study (CAHPS®) was designed to assess the interpersonal care of children based on parental responses. Field testing of the survey revealed that 3,083 Washington State employees who were insured through the State employee benefits program rated personal doctors most highly. They rated overall care and specialty care nearly as well and rated plan administration lowest. Parent-doctor and child-doctor communication, as well as spending sufficient time with the child, appeared most important to families in their assessments of overall care and of personal doctors.

Parents generally reported positive experiences with their child's health care. They rated their personal doctor's care as high quality (8.37 on a 0-10 scale), and they viewed the overall quality of care and care provided by their child's specialist only slightly less well (8.27 and 8.21, respectively). The mean overall rating of the health plan was lower (7.07). Almost all parents (88 percent) reported that it was easy to find a personal doctor among the plan's choices, and 82 percent indicated they were always or usually able to get help when they phoned their doctor.

Access to specialists was more difficult. Among those whose child needed to see specialists in the past 6 months, 13.4 percent reported the child was not able to see a specialist, and 25 percent noted it was not easy to get a specialty referral when needed. Performance in the more administrative aspects of health care, such as waiting times, was rated lower but did not influence the overall experience as strongly as the physician relationship, according to the researchers. Their work was supported in part by the Agency for Health Care Policy and Research (HS09205).

See "The Consumer Assessment of Health Plan Study (CAHPS®) survey of children's health care," by Charles J. Homer, M.D., M.P.H., Floyd J. Fowler, Ph.D., Patricia M. Gallagher, and others, in the July 1999 Joint Commission Journal on Quality Improvement 25(7), pp. 369-377.

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