Well-Child Care Redesign: A New Model of Care for Children in Low-Income Families
Grantee: University of California, Los Angeles
Principal Investigator: Tumaini Coker
Project Number: R40MC21516
Project Date: 2/1/2011
Final Report
Well-Child Care Redesign: A New Model of Care for Children in Low-Income Families Final Report (PDF)
Age group(s)
- Perinatal/Infancy (0-12 months)
- Toddlerhood (13-35 months)
- Early Childhood (3-5 years)
Abstract
Well-child visits early in childhood may be the only opportunity before a child reaches preschool to identify and address important social, developmental, behavioral, and health issues. Early and aggressive attention to these issues may have substantial long-term health benefits. Moreover, the failure of individuals to reach their full developmental potential or to avoid chronic debilitating diseases may generate crippling costs both to economic productivity and to the social welfare, criminal justice, and health care systems. In our current system of well-child care, the opportunity for action through preventive health services is often missed - many children and families routinely receive inadequate quantity and/or quality of services. These deficiencies in care are often greatest for children in low-income families. In light of these deficiencies, pediatricians and researchers have begun to describe "well - child care redesign" as an agenda for change in child preventive health services. Efforts toward redesign aim to radically alter the current system of well-child care beyond what more modest and incremental quality improvement campaigns can achieve. In partnership with the largest public health plan in the United States, L.A. Care, we will combine the perspectives of three major well-child care stakeholder groups - providers, parents, and payors (e.g., health plans) - with a community advisory board and expert panel to design and pilot test a new model for the delivery of well-child care to children ages 0-3 years. This new model of care will be developed using a framework that considers alternative structures for care: non-physician providers (nurses, lay health educators, social workers), nontraditional formats (group visits, internet, phone), and non-clinical locations (daycare centers, home visits, grocery stores) for well-child care services. Input from the well-child care stakeholder groups, the community advisory board, and the expert panel will help to create not only a model that will be patient-centered, sustainable, and feasible for use with L.A. Care's pediatric members, but also a redesign methodology that will be reproducible for other health plans and communities.Publications
Listed is descending order by year published.
Coker TR, Moreno C, Shekelle PG, Schuster MA, Chung PJ. Well-child care clinical practice redesign for serving low-income children. Pediatrics. 2014 Jul;134(1):e229-39. doi: 10.1542/peds.2013-3775. Epub 2014 Jun 16. PMID: 24936004
Mooney K, Moreno C, Chung PJ, Elijah J, Coker TR. Well-child care clinical practice redesign at a community health center: provider and staff perspectives. J Prim Care Community Health. 2014 Jan 1;5(1):19-23. doi: 10.1177/2150131913511641. Epub 2013 Dec 5. PMID: 24327599
Coker TR, Thomas, T, Chung, PJ. Does well-child care have a future in pediatrics? Pediatrics 2013;131:S149-59
Coker TR, Windon A, Moreno C, Schuster MA, Chung PJ. Well-child care clinical practice redesign for young children: a systematic review of strategies and tools. Pediatrics 2013; 131:S5-25. doi: 10.1542/peds.2012-1427c. Review. PMID: 2345719
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