Beth A Pletcher1, Mary Ellen Rimsza2, William L Cull3, Scott A Shipman4, Richard P Shugerman5, Karen G O'Connor3. 1. Department of Pediatrics, UMDNJ - New Jersey Medical School, Newark, NJ. Electronic address: pletchba@umdnj.edu. 2. Department of Pediatrics, University of Arizona, Tucson, AZ. 3. Department of Research, American Academy of Pediatrics, Elk Grove Village, IL. 4. Department of Pediatrics, Dartmouth Medical School, Lebanon, NH. 5. Department of Pediatrics, University of Washington, Seattle, WA.
Abstract
OBJECTIVES: To compare satisfaction with specialty care by primary care pediatricians (PCPs), perceived barriers to care, and adequacy of specialist supply. STUDY DESIGN: A survey of U.S. pediatricians was conducted in 2007. PCPs were asked about satisfaction with specialty care for their patients, as well as supply of specific pediatric subspecialists. Responses of rural and nonrural PCPs were compared regarding 10 potential barriers to care. RESULTS: Most PCPs are satisfied with the quality of subspecialty care. However, they were not satisfied with wait times for appointments, and the availability of many pediatric medical subspecialties and several pediatric surgical specialties. Rural PCPs were significantly more likely to report these shortages compared with nonrural pediatricians; these included 9 of the 18 medical and 5 of the 7 surgical specialties. In addition to wait times for appointments, PCPs reported that subspecialists' nonparticipation in health insurance plans and lack of acceptance of uninsured patients were also barriers to obtaining subspecialty care for their patients. CONCLUSIONS: PCPs provide valuable insight into access to the pediatric subspecialty workforce. This survey of PCPs raises significant concerns about the adequacy of children's access to pediatric subspecialists, especially in rural communities.
OBJECTIVES: To compare satisfaction with specialty care by primary care pediatricians (PCPs), perceived barriers to care, and adequacy of specialist supply. STUDY DESIGN: A survey of U.S. pediatricians was conducted in 2007. PCPs were asked about satisfaction with specialty care for their patients, as well as supply of specific pediatric subspecialists. Responses of rural and nonrural PCPs were compared regarding 10 potential barriers to care. RESULTS: Most PCPs are satisfied with the quality of subspecialty care. However, they were not satisfied with wait times for appointments, and the availability of many pediatric medical subspecialties and several pediatric surgical specialties. Rural PCPs were significantly more likely to report these shortages compared with nonrural pediatricians; these included 9 of the 18 medical and 5 of the 7 surgical specialties. In addition to wait times for appointments, PCPs reported that subspecialists' nonparticipation in health insurance plans and lack of acceptance of uninsured patients were also barriers to obtaining subspecialty care for their patients. CONCLUSIONS: PCPs provide valuable insight into access to the pediatric subspecialty workforce. This survey of PCPs raises significant concerns about the adequacy of children's access to pediatric subspecialists, especially in rural communities.
Authors: Kristin N Ray; Jill R Demirci; Debra L Bogen; Ateev Mehrotra; Elizabeth Miller Journal: Telemed J E Health Date: 2015-04-28 Impact factor: 3.536
Authors: Alon Peltz; Chang L Wu; Marjorie Lee White; Karen M Wilson; Scott A Lorch; Cary Thurm; Matt Hall; Jay G Berry Journal: Pediatrics Date: 2016-04-11 Impact factor: 7.124
Authors: Daniel M O'Connor; Olivia S Jew; Marissa J Perman; Leslie A Castelo-Soccio; Flaura K Winston; Patrick J McMahon Journal: JAMA Dermatol Date: 2017-12-01 Impact factor: 10.282
Authors: Kristin N Ray; Laura Ellen Ashcraft; Ateev Mehrotra; Elizabeth Miller; Jeremy M Kahn Journal: Telemed J E Health Date: 2017-04-21 Impact factor: 3.536