Pediatric Subspecialty

Capacity

Pediatric Subspecialty Capacity Initiative

     The pediatric subspecialty capacity initiative seeks to improve children’s access to pediatric subspecialists and to strengthen the interface between primary and specialty pediatric care.  In 2004, a Federal Expert Work Group on Pediatric Subspecialty Capacity was formed with funding from the Maternal and Child Health Bureau and with staff support from the MCH Policy Research Center.  The Expert Work Group will continue meeting through 2007.  It is comprised of leaders from the American Academy of Pediatrics, American Board of Pediatrics, American Academy of Child and Adolescent Psychiatry, Association of American Medical Colleges, Child Health Corporation of America, Family Voices, National Association of Children’s Hospitals, and federal and state government agencies. The Expert Work Group has three main objectives: 1) define the scope of current and projected pediatric subspecialty capacity problems and their consequences; 2) identify promising approaches for improving shared management between pediatric subspecialists and medical homes, reimbursement, continuing education and training, and state/regional delivery system networks; and 3) develop recommendations and a tactical plan to improve access to subspecialty care.

     Access to pediatric subspecialty care is a serious problem in many parts of the United States. Families, physicians, hospitals, managed care organizations, academic institutions, health services researchers, and state health agencies increasingly have been reporting acute access difficulties in almost every pediatric medical and surgical subspecialty, including, but not limited to, child and adolescent psychiatry, neurology, developmental-behavioral pediatrics, rheumatology, nephrology, gastroenterology, and neurosurgery.  The consequences of such difficulties are profound and significantly impact health outcomes and the costs of care. There is no single cause of the access difficulties and efforts to address the problem must consider multiple interrelated areas from both the provider and family perspectives, including primary-specialty care interface, financing, education, and organization of state and regional delivery systems.