title: Group well-child care: an analysis of cost.
abstract: OBJECTIVE
  To determine if group well-child visits (WCV) can be cost neutral compared with individual WCV by varying health care providers, group size, and physician salary.
  
  
  METHODS
  We created 6 economic models to evaluate the costs of WCV: 3 for individual WCV delivered by (1) advanced practice registered nurse (APRN), (2) resident, and (3) attending and 3 for group WCV delivered by (4) APRN with a nurse and social worker; (5) resident with an attending, nurse, and child life specialist; and (6)attending with a nurse. For group WCV, we performed sensitivity analyses on group size and duration of provider participation.
  
  
  RESULTS
  We achieved cost-neutrality at 4 families in the APRN group WCV model; at 3, 4, 5, and 6 families in the resident model with 30, 45, 60, and 90 minutes of attending supervision, respectively; and at 4 and 5 families in the low and high attending salary model, respectively.
  
  
  CONCLUSIONS
  Group WCV can be delivered in a cost-neutral manner by optimizing group size and provider participation.
authors: 1University of Washington, Seattle, WA, USA.
authors: Hiromi
authors: H
authors: Yoshida
authors: Ada M
authors: AM
authors: Fenick
authors: Marjorie S
authors: MS
authors: Rosenthal
mesh_terms: D057179:Advanced Practice Nursing / Q000191:economics; D002662:Child Health Services / Q000191:economics*; D002669:Child Welfare / Q000191:economics*; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D006801:Humans; D007223:Infant; D007396:Internship and Residency / Q000191:economics; D017146:Models, Organizational; D009726:Nurses / Q000191:economics*; D010820:Physicians / Q000191:economics*; D011320:Primary Health Care / Q000191:economics*; D012947:Social Work / Q000191:economics*
keywords: cost analysis; group well-child care; primary care; well-child care; well-child visit