The Future of Well-Child Care in Pediatrics

Introduction: Ideally, well-child care (WCC) helps create healthier adults with more productive lives and lower health care costs. For children without serious acute and chronic medical problems, however, traditional pediatric preventive services may be largely ineffective in addressing the outcomes that really matter; that is, improving lifelong health and reducing the burden of adult chronic disease. Method: A systematic search was used to review relevant research and clinical reviewarticles, Result: understanding the value of health care services today is critical, and gauging the value of WCC has always been undermined by uncertainty regarding which outcomes are important. If we believe that preventing or reducing the impact of poverty, poor educational outcomes, unhealthy social and physical environments, and unhealthy life- style choices is critically important for lifelong health, then we should evaluate WCC, in part, by its ability to contribute to that end. Conclusion: There may be several options for the future of WCC, but they likely fit into 1 of 2 basic choices: (1) radically change the model of WCC within the field of pediatrics so that it can actually address the critical nonmedical childhood drivers of adult health; or (2) rethink whether pediatrician-provided WCC should exist at all.

Keywords:

chronic disease , health economics , primary care , well-child care