Knowing which treatments work and which don't is an important first step in improving children's health care, but it's not enough

Sep 14 2004

University of South Florida pediatrician Dr. Lisa Simpson says she knew enough to ignore a physician’s recommendation that treating repeated ear infections with ear tubes was important to her son’s eventual speech and language outcomes.

In fact, several studies have shown ear tubes are unnecessary for most children, even those with repeated ear infections, and the procedure may result in more ear drum abnormalities.

“But what about countless other parents who rely on physicians and health care systems to provide high-quality care based on the best evidence?” said Dr. Simpson, who holds the All Children’s Hospital Guild Endowed Chair in Child Health Policy.

Knowing which treatments work and which don’t is an important first step in improving children’s health care, but it’s not enough, Simpson reports in the September/October issue of the journal Health Affairs. “How do you get providers – children, families, systems or policymakers – to do what works? This question is key to our ability to change practice or policy.”

Dr. Simpson was the advisor for the special theme issue of the journal Health Affairs, devoted to assessing the state of the country’s investment in children’s health care and outcomes. Her article, “Lost in Translation? Reflections on the Role of Research in Improving Health Care for Children,” was included in the issue.

Dr. Simpson suggests three strategies that could accelerate progress in improving the quality of children’s health care:

• Increase federal support to promote research that focuses on what it takes to advance health initiatives for children.
• Create a national team of experts in evidence-based practice, quality improvement and translational research. This elite corps could be deployed to states and cities to work with private health care providers, systems and insurance plans to improve children’s health.
• Make vulnerable children -- those at high risk for worse health care outcomes -- high priority. “Although quality problems spare no child the burden of illness falls disproportionately on a subset of children,” Dr. Simpson said. “Indeed, 20 percent of children continue to account for 80 percent of all pediatric health care spending.”