Person:

Perrin, James

The authors of this paper identify risks to health and other factors that determine the need for health care services among children and adolescents. They document service utilization patterns in the areas of well-child care and immunizations, acute ambulatory care and hospital services, and injury prevention. They also acknowledge the special health care needs of adolescents and of children with chronic illnesses. It appears that neither the traditional personal health service delivery system nor the public health system alone can effectively provide all of the health services children need. Collaboration between public health and personal health service providers is essential to future efforts to improve the health of children and adolescents. Recommendations include development of community-based preventive care programs in all parts of the country, extension of current traditional primary care capabilities, assurance of access to primary care services, enhancement of public health activities, expansion of specialized adolescent health programs, and coordination of a comprehensive set of medical and other services for children with chronic illness and their families. The authors conclude that, to be effective, future health system reforms must be implemented through a coordinated program of care rather than through competing systems of services.