Access to health care, the timely use of personal health services to achieve the best possible health outcomes, remains a fundamental problem for children in the United States. To date, research and interventions addressing children’s access to care have largely focused on policy-level features of the health care system (such as health insurance and geographic availability of providers) with some, although limited, success. Ultimately, access to health care implies entry into the health care system. Practice scheduling systems are the point of entry to primary care health services for children and thus directly determine access to care in pediatric and family medicine practices. Here we explore the rationale for improving access to care for children from an additional angle: through improving practice scheduling systems. It is our hypothesis that some of the most promising contemporary interventions to improve children’s access involve improving primary care scheduling systems. These approaches should complement successful policy-level interventions to improve access to care for children.
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March 2004
Electronic Articles|
March 01 2004
Behind Schedule: Improving Access to Care for Children One Practice at a Time
Greg D. Randolph, MD, MPH;
Greg D. Randolph, MD, MPH
*North Carolina Center for Children’s Healthcare Improvement, Chapel Hill, North Carolina
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Mark Murray, MD, MPA;
Mark Murray, MD, MPA
‡Mark Murray and Associates, Sacramento, California
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Jill A. Swanson, MD;
Jill A. Swanson, MD
§Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
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Peter A. Margolis, MD, PhD
Peter A. Margolis, MD, PhD
*North Carolina Center for Children’s Healthcare Improvement, Chapel Hill, North Carolina
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Address correspondence to Greg D. Randolph, MD, MPH, North Carolina Center for Children’s Healthcare Improvement, 730 Airport Rd, CB 7226, Chapel Hill, NC 27599-7226. E-mail: randolph@unc.edu
Pediatrics (2004) 113 (3): e230–e237.
Article history
Received:
August 06 2003
Accepted:
November 20 2003
Citation
Greg D. Randolph, Mark Murray, Jill A. Swanson, Peter A. Margolis; Behind Schedule: Improving Access to Care for Children One Practice at a Time. Pediatrics March 2004; 113 (3): e230–e237. 10.1542/peds.113.3.e230
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