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Assessing & Developing Primary Care for Children

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Assessing & Developing Primary Care for Children DOCUMENT RESUME ED 392 537 PS 024 020 AUTHOR Grason, Holly Allen, Ed.; Guyer, Bgrnard, Ed. TITLE Assessing & Developing Primary Care for Children: Reforms in Health Systems. INSTITUTION National Center for Education in Maternal and Child Health, Arlington, VA. SPONS AGENCY Health Resources and Services Administration (DHHS/PHS), Washington, DC. Maternal and Child Health Bureau. REPORT NO ISBN-1-57285-025-6 PUB DATE 95 CONTRACT MCU-243A19; MCU-117007 NOTE 271p. AVAILABLE FROMNational Maternal and Child Health Clearinghouse, 2070 Chain Bridge Road, Suite 450, Vienna, VA 22182-2536 (single copy, free). PUB TYPE Collected Works - Conference Proceedings (021) Viewpoints (Opinion/Position Papers, Essays, etc.) (120) -- Reports Evaluative/Feasibility (142) EDRS PRICE MF01/PC11 Plus Postage. DESCRIPTORS Adolescents; At Risk Persons; *Child Health; *Childhood Needs; Children; Child Welfare; Delivery Systems; Family Health; Government Role; *Health Services; Preventive Medicine; *Primary Health Care; Public Health IDENTIFIERS Alabama; Arizona; *Health Care Reform; Iowa; Service Delivery Assessment ABSTRACT This publication is a compilation of papers presented at an April 1994 workshop sponsored by the National Center for Education in Maternal and Child Health and the Bureau-funded Johns Hopkins Child and Adolescent Health Policy Center (CAHPC). The papers are as follows: (1) "Defining the Issues and Planning for Change: Health Care Systems, Primary Care, and Reform" (David Heppel); (2) "Health Care systems and Primary Care for Children and Adolescents: Overview and Context" (Bernard Guyer and others); (3) "Delineating Public Roles in Planning, Providing, and Evaluating Primary Care Services for Children and Their Families: Les Nouveax Miserables--Modern Victims of Social Asphyxia" (David R. Smith);(4) "Assessing the Status of Primary Care Services: A Working Approach" (Barbara Starfield); (5) "Developing Population-Based Datasets at National, State, and Local Levels: Potential and Promise" (Deborah Klein Walker); (6) "Assessing the Status of Primary Care Services: Early Experiences of the Child and Adolescent Health Policy Center in Evaluating Primary Care" (Charlyn E. Cassady); (7) "Assessing Needs and Monitoring Progress in the Delivery of Primary Care Services for Children and Youth" (David M. Stevens and others);(8) "Community System Assessment and Child Health Planning in Iowa" (Charles E. Danielson and others); (9) "Evaluating the Delivery of Pediatric Primary Care in New York City" (Lucille Rosenbluth); (10) "Accountability in Primary Health Care Systems: Conceptual Frameworks and Policy Challenges" (Bernard Guyer and others); (11) "Primary Care Provider and System Challenges in Caring for High-Risk Children and Families" (Larry Culpepper); (12) "Meeting the Contemporary Needs of Children and Youth with Developing Primary Care Systems: Issues for Pediatricians in Health Care Reform" (Susan Aronson); (13) "CHIP--A Community Model for a Comprehensive Health Care System" (Peggy Balla); (14) "Pediatric Primary Care Systems Development Initiatives in Arizona" (Jane Pearson);(15) "Health Care Reform and Public Health Consideration in Alabama" (Larry Menefee); (16) "Public Health and Health Care Reform: Healthy People in Healthy Communities" (Martin Wasserman); (17) "What's Needed to Move Forward? State MCH Program Perspectives" (Maxine Hayes); and (18) "Commentary and Closure" (Bernard Guyer). Two appendices include the workshop agenda and a list of participauZs. (DR) U S DEPARTMENT OF EDUCATION Mc. of Eiucabonal flosearcil and Implownifol EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) %Th.. document has been reproduced as received from the person or organization originating it O Minor changes have been made to improve reproduction quality Points of view or opinions stated in this document do not necessarily represent official OERI position or policy Assessing Developing Primary Care FOR Children g-Ct.1 REFORMS IN C1 HEALTH SYSTEMS -11 Assessing & Developing Primary Care for Children REFORMS IN HEALTH SYSTEMS Edited by Holly Allen Grason, M.A. Bernard Guyer, M.D., M.P.H. Supported by Maternal and Child Health Bureau iealth Resources and Services Administration Public Health Services U.S. Department of Health and Human Services Published by National Center for Education in Maternal and Child Health Arlington, Virginia Cite as Grason HA,Guyer B, eds. 1995. Assessing and Developing Primary Care for Children: RelOrms in Health Svstems. Arlington, \ A: National Center for Education in Maternal and Child Health. Assess* and Developing Primary Care br Children: Relivms in Health Systems is not copyrighted. Readers are free to duplicate and use all or part of the intOrmation contained in this publication. In accordance with accepted publishing standards, the National Center for Education in Nlaternal and Child Health (NCENICII) requests acknowledgment, in print, of any intOrmation reproduced in another publication. The Chikl and Adolescent Health Policy Center (CAH PC) at The Johns Hopkins University was established in 1991 by the federal Mater nal and Child liealth Bureau as one of two centers to address new challenges found in amendments to Title V of the Social Security Act (MCH Services Block Grant) enacted in the Omnibus Budget Reconciliation Act of 1989 (OBRA '89). The purpose of WU CAIIPC is to draw upon the science base of the university setting to help identify and solve key MCII policy issues regarding the development and implementation of comprehensive, community-based sys tems of health care services for children and adolescents. Projects are conducted to provide information and analytical tools useful to both the federal Nlaternal and Child I lealth Bureau and the state Title V programs as they seek to meet the spirit, intent, and content of the Title V legislation and the challenges of addressing the unique needs of MCI! populations and programs in health care reform. CAH PC is located at The Johns Hopkins University, School of Hygiene and Public Health, Department of Maternal and Child Health, 624 North Broadway, Baltimore, MD 21205. Phone: (410) 550-5443. The mission of the National Center for Education in Maternal and Child Health is to promote and improve the health, education, and well-being of children and families by leading a national eltOrt to collect, develop, and disseminate infor- matitm and educational materials on maternal and child health; and by collaborating with public agencies, voluntary and professional organizations, research and training programs, policy centers, and others to advance knowkdge in pro- grams, service delivery, and policy development. Established in 1982 at Georgetown University, NCEMCH is part of the Graduate Public Policy Program. NCEMCH is funded primarily by the U.S. Department of Ikalth and Human Services through its Nleternal and Child Health Bureau. Assessing and Developing Primary Care for Children: Reliwins in Health Systems was published by the National Center for Education in Maternal and Child I lealth, 2000 13th Street North, Suite 701, Arlington, \ A 22201-2617. phone: (703) 52.1_ 7802, fax: (703) 524-9335, Internet: ncemehOlOyumedlib.dml.georgetown.edu. library of Congress Catalog Card Number 95-72689 ISBN 1-57285-025-6 Single copies of this publicathw are available at no i-ost from: National Maternal and Child Ilealth Clearinghouse 2070 Chain Bridge Road, Suite 450 Vienna, VA 22182-2536 (703) 821-8955 (703) 821-2098 fax Ibis document was developed by the /Ill' ( 'A 111'f under its coopel at ire agreement ( 19) with the Ahnernal and Child /loath Bureau, Health Resources and Services Administrat ion, 1'.S. l)epartment of Health and Human Services. The publicatimi Mis produced bv the National Center.for Mtn alio,: in Maternal and Child Health under its cooperative agree. ment (Alt l ;00;) with the Maternal and Chihl lealth Table of Contents Acknowledgments Preface vii Contribwors Xi Overview xiii Defining the Issues and Planning for Change: Health Care Systems, Primary Care, and Reform by David Heppel11.1). Health Care Systems and Primary Care for Children and Adolescents: Overview and Context 9 by Bernard Guyer M.D., KPH., Mona Shediac, Ph.D., Char lyn Cassady; Ph.D., aml Holly Grason, M.A. Delineating Public Roles in Planning, Providing, and Evaluating Primary Care Services for Children and Their Families: Les Nouveax MiserablesModern Victims of Social Asphyxia 23 by David R. Smith, M.D. Assessing the Status of Primary Care Services: A Working Approach 39 by Barbara StaqieldILD., M.PH. Developing Population-Based Data Sets at National, State, and Local Levels: Potential and Promise 49 by Deborah Klein Walker, Ed.D. Assessing the Status of Primary Care Services: Early Experiences of the Child and Adolescent Health Policy Center in Evaluating Primary Care 65 by Char lyn E. Cassad); Ph.D. Assessing Needs and Monitoring Progress in the Delivery of Primary Care Services for Children and Youth 79 by David M. Ytevens, M.D., EA.A.EP, Rita A. Goodman, R.N.C., M.S., and Norma 1. Campbell, M.A. Community System Assessment and Child Health Planning in Iowa 97 by aarles DanielsonV.D., M.P.H., Mary Anderson, M.A., and Kay Leeper, M.S.N. Evaluating the Delivery of Pediatric Primary Care in New York City 107 by Lucille RosenbluthIL PA. Accountability in Primary Health Care Systems: Conceptual Frameworks and Policy Challenges 119 by Bernard Guyer, ALD., M. PH., Mona Shediac, Ph.D., and Holly Grason, M.A. Primary Care Provider and System Challenges in Caring for High-Risk Children and
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