Discussion of Illness During Well-Child Care Visits With Parents of Children with and without Special Health Care Needs

Well-child care visits in pediatric practice are an opportunity for physicians to deliver preventive care and promote general health and development. In this study, the researchers surveyed the parents of patients before and after well-child care visits to determine what parents of children with special health care needs (CSHCN) expect, prioritize and receive during visits compared to parents of children without special health care needs.

The researchers surveyed 500 parents from two community-based pediatric practices in suburban southeast Michigan. The results showed that parents of CSHCN were more likely to expect to discuss one illness topic 92 percent of the time compared with 81 percent of the time for parents of children without special needs. Parents of children without special health care needs expected to discuss a recent illness, whereas parents of CSHCN focused on their child's chronic condition and the effect of health problems on life overall. Contrary to results from previous studies, for both types of parents, the physician delivered more preventive care when more discussion about illnesses occurred. Moreover, physician's failure to mention expected illness topics was associated with lower visit satisfaction for both types of parents. Findings in this study are relevant for clinical experts and policy-makers who design guidelines for health supervision visits.

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