title: Duration of a well-child visit: association with content, family-centeredness, and satisfaction.
abstract: BACKGROUND
  Studies of pediatric primary care suggest that time is an important limitation to the delivery of recommended preventive services. Given the increasingly frenetic pace of pediatric practice, there is an increased need to monitor the length of pediatric visits and the association of visit length with content, family-centered care, and parent satisfaction with care.
  
  
  OBJECTIVE
  To examine the length of well-child visits and the associations of visit length with content, family-centered care, and parent satisfaction among a national sample of children.
  
  
  METHODS
  We conducted a cross-sectional telephone survey of parents of children aged 4 to 35 months from the 2000 National Survey of Early Childhood Health (n = 2068).
  
  
  RESULTS
  One-third (33.6%) of parents reported spending ≤ 10 minutes with the clinician at their last well-child visit, nearly half (47.1%) spent 11 to 20 minutes, and 20.3% spent >20 minutes. Longer visits were associated with more anticipatory guidance, more psychosocial risk assessment, and higher family-centered care ratings. A visit of >20 minutes was associated with 2.4 (confidence interval [CI]: 1.5-3.7) higher odds of receiving a developmental assessment, 3.2 (CI: 1.7-6.1) higher odds of recommending the clinician, and 9.7 (CI: 3.5-26.5) higher odds of having enough time to ask questions.
  
  
  CONCLUSIONS
  Many well-child visits are of short duration, and shorter visits are associated with reductions in content and quality of care and parent satisfaction with care. Efforts to improve preventive services will require strategies that address the time devoted to well-child care. The results of this study should be interpreted in light of changes in practice standards, reimbursement, and outcome measurement that have taken place since 2000 and the limitations of the measurement of utilization solely on the basis of parent report.
authors.affiliation: Department of Pediatrics, UCLA Center for Healthier Children, Families, and Communities, David Geffen School of Medicine, Los Angeles, California 90024, USA. nhalfon@ucla.edu
authors.forename: Neal
authors.initials: N
authors.lastname: Halfon
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Stevens
authors.forename: Kandyce
authors.initials: K
authors.lastname: Larson
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Olson
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000706:statistics & numerical data; D010372:Pediatrics; D010808:Physical Examination / Q000592:standards / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000592:standards / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States