Role of Partnerships: Second Annual Meeting of Child Health Services R

Keynote Address: Random Thoughts by a Non-Pediatrician

Second annual meeting held to explore the state of the science in children's health services research.

Keynote Address: Random Thoughts by a Non-Pediatrician

Presenter:

Robert Brook, M.D., Sc.D.
Vice President and Director, RAND Health

Dr. Brook exhorted the audience to "break out of the box" in developing solutions to problems with the delivery of child health care today. He began by emphasizing that for most children, the role of the medical delivery system is of marginal importance compared to other settings such as the school, home, and community environments in which children live, and he challenged people to "be leaders in the effort to cut across service systems". Dr. Brook further emphasized that those children who are the most frequent users of the medical system are most often those ignored by society or those who suffer from socioeconomic disadvantages.

To bring about change, a "revolution in conceptualizing healthcare delivery for children," new strategies are needed. These include:

  • Building a constituency and support beyond what currently exists.
  • Integrating with and providing support for the public health and education systems.
  • Involving parents more directly, particularly those with severely impaired children who suffer from more than one chronic disease.

At the same time, while developing these strategies, child health services researchers also need to address several key goals of the U.S. health care system today. The first goal is to define what is "necessary care." Dr. Brook raised the possibility that perhaps "necessary care" goes beyond medical treatment of acute care needs to incorporate more proactive and broader approaches, for example, informing teens in a positive context about the issues of drinking and safe sex.

A second goal of the health care system is to eliminate waste, or provide what is necessary more efficiently. The cost of care should not exceed the benefit, and, ultimately, rooting out waste will result in more support for insurance coverage.

A third goal is to improve the mean level of the quality of care, with regard to appropriateness, excellence and satisfaction. One of the most difficult aspects of improving quality is creating incentive structures that provide for good quality. One of the critical roles of child health services researchers in this regard will be to look at how to help pediatricians and other providers of care for children maintain their knowledge of what is effective care as new knowledge is discovered. As Dr. Brook noted, "physicians read little, and often treat patients without really knowing the right answer".

Ultimately, change in child health care must be tied to developments not only in clinical knowledge and service delivery, but also in the development of social support systems across multiple health, education, and welfare needs of children.

Current as of June 2000


Internet Citation:

Keynote Address: Random Thoughts by a Non-Pediatrician. Role of Partnerships: Second Annual Meeting of Child Health Services Researchers. June 27, 2000. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/chsr2key.htm


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Current as of June 2000
Internet Citation: Role of Partnerships: Second Annual Meeting of Child Health Services R: Keynote Address: Random Thoughts by a Non-Pediatrician. June 2000. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/other/chsr2/chsr2key.html