Does Having a Regular Primary Care Clinician Improve Quality of Preventive Care for Young Children?

Published In: Medical Care, v. 46, no. 3, Mar. 2008, p. 323-330

Posted on RAND.org on December 31, 2007

by Moira Inkelas, Paul W. Newacheck, Lynn M. Olson, Barry Zuckerman, Mark A. Schuster

Read More

Access further information on this document at journals.lww.com

This article was published outside of RAND. The full text of the article can be found at the link above.

OBJECTIVE: This study examines whether having a regular clinician for preventive care is associated with quality of care for young children, as measured by interpersonal quality ratings and content of anticipatory guidance. DATA SOURCE: The National Survey of Early Childhood Health (NSECH), a nationally representative parent survey of health care quality for 2068 young US children fielded by the National Center for Health Statistics (NCHS). STUDY DESIGN: Bivariate and multivariate analyses evaluate associations between having a regular clinician for well child care and interpersonal quality, the content of anticipatory guidance, and timely access to care. PRINCIPAL FINDINGS: In bivariate analysis, parents of children with a regular clinician for preventive care reported slightly higher interpersonal quality (69 vs. 65 on a 0-100 scale, P = 0.01). Content of anticipatory guidance received was slightly greater for children with a regular clinician (82 vs. 80 on a 0-100 scale, P = 0.03). In bivariate analysis, a regular clinician was associated with interpersonal quality only among African American and Hispanic children. In multivariate analyses, controlling for factors that could independently influence self-reports of experiences with care, interpersonal quality but not anticipatory guidance content was higher for children with a regular clinician. CONCLUSIONS: Having a regular primary care clinician is embraced in pediatrics, although team care among physicians is also widely practiced. For young children, having a regular clinician is associated with modest gains in interpersonal quality and no differences in content of anticipatory guidance. The benefit of having a regular clinician may primarily occur in interpersonal quality for subgroups of young children.

This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.