title: Services for children and youth with chronic health conditions: views of pediatricians in British Columbia.
abstract: Canadian research on health services for children and youth with chronic health conditions (CHC) is limited. In a postal survey, pediatricians in British Columbia rated the quality and safety of health care services for children with chronic medical conditions (Ch-Med) lower (mean rating +/- SD on a seven-point scale: 4.86 +/- 1.02 ) than services for children with acute conditions/injuries (5.97 +/- 1.01), and lowest for children with chronic developmental, behavioral and mental health conditions (Ch-DBM; 3.06 +/- 1.17). To improve health care services for CHC, respondents especially favoured improving access to community-based services and resources and to medical specialists and specialized facilities, and the implementation of alternative models of care. Respondents indicated that physician care of children with CHC could be enhanced by extending the physician's role, better integrating medical with other aspects of care and adopting more flexible payment mechanisms. Findings suggest the need for enhancement and innovation in medical services for children with CHC, especially Ch-DBM, but also that solutions need to take account of CHC subcategory, geographic factors and differences in practitioner readiness to embrace change.
authors.affiliation: Department of Pediatrics, University of British Columbia, Vancouver, Britsh Columbia, Canada. amiller@cw.bc.ca
authors.forename: Anton R
authors.initials: AR
authors.lastname: Miller
authors.forename: Magda
authors.initials: M
authors.lastname: Recsky
authors.forename: Mojgan
authors.initials: M
authors.lastname: Ghazirad
authors.forename: Michael
authors.initials: M
authors.lastname: Papsdorf
authors.forename: Robert W
authors.initials: RW
authors.lastname: Armstrong
mesh_terms: D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D001955:British Columbia; D016009:Chi-Square Distribution; D002648:Child; D002662:Child Health Services / Q000592:standards*; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics / Q000592:standards*; D010820:Physicians / Q000523:psychology*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires