Routine health care lags for children: study

By Gene Emery

BOSTON (Reuters) - U.S. children are receiving less than half the routine care they need, even if they are covered by health insurance, researchers said on Wednesday.

"We're talking about the basics of what we should be providing, and in many cases it's just not happening," said Dr. Rita Mangione-Smith of the University of Washington in Seattle, who led the study.

Shortfalls were seen in vaccinating children on time, providing recommended asthma care and even monitoring growth. Parents may need to read up on needed care and come in to checkups armed with checklists, Mangione-Smith said.

The study comes amid debate over expanding childhood access to health insurance programs. Mangione-Smith's team looked at whether children were receiving all the treatment they need, even those covered by insurance.

Nurses reviewed medical records from 1,536 children and teens from 12 metropolitan areas and found that they received recommended care less than 47 percent of the time in areas ranging from basic immunizations to treatment for infections.

Nationwide, the percentage may be even lower.

Nearly 82 percent of children in this study were covered by private health insurance, so "we would expect these children to have a higher quality of care than the average child," Mangione-Smith and her colleagues wrote in their report, published in the New England Journal of Medicine.

"Their observations are shocking: the right services appear to be carried out less than half the time. Services are not delivered when they should be, or they are delivered when they should not be," Dr. James Perrin and Dr. Charles Homer of Harvard Medical School wrote in a commentary.