Converting child health stations to pediatric treatment centers.

Nineteen child health stations in New York City have added treatment services to their traditional role of well-child supervision with the objective of increasing the access of children livine in underserved areas to integrated preventive and therapeutic care. The conversion process was studied at nine pediatric treatment centers (PTC) in upper Manhattan and the South Bronx. the Department of Health accomplished the conversion by adding full-time pediatricians, on-premises laboratory capability, prepackaged pharmacies, and informal arrangements with local hospitals. The proportion of patient visits at the PTCs for sick care ranged from 11 to 57 per cent and varied with the length of time the unit had been in operation. Personnel cost per visit was $16. Six child health stations were compared before and after conversion to PTCs. Registration increased 5 per cent, visits increased 50 per cent, and personnel cost increased 150 per cent. Review of 600 patient visits revealed that the majority of illness visits were for minor conditions, notably upper respirtory infections. Interviews of 600 parents of three PTCs revealed that approximately one-fourth regarded the PTC as a usual source of care. Increased access and continuity of child health services have been accomplished by these conversions. Adding treatment services to child health stations is a satisfactory alternative to the overcrowded hospital-based pediatric facility.