APA: Past, Present and FutureFuture of Academic General Pediatrics—Areas of Opportunity
Section snippets
Public Policy
Children and adolescents typically receive only a relatively small proportion of public financing, especially for health. As an example, only about 9%–10% of health care expenditures are for children and youth under 18 years old.4, 5 Although recent years have not brought much change in investment levels, increasing evidence has supported the value of early investment,6 including 2 key national reports, Neurons to Neighborhoods7 and Children’s Health—The Nation’s Wealth.8 The case for long-term
Patient Care
In the area of patient care there are at least 5 domains that provide opportunity (Table 1). These include systems-based and team care, use of information technology and social media, application of quality improvement in diverse populations and individual care, inclusion of public health and nonmedical community resources in improving child health, and the interface between inpatient and outpatient care. Each has great potential for improving child health, but also has inherent challenges that
Education
Increased attention to the effectiveness and efficiency of training in the next decade will also enhance appreciation of the science of medical education—the often undervalued third leg of the classic triad in academic medicine. In pediatric medical education, at least 3 trends provide future direction and opportunity for academic generalists (Table 2). These trends include: formal training in education theory and skills, including research; use of information technology; and the development
Databases and Analyses
Research in child health, especially the types of research carried out in academic general pediatrics, has much opportunity for change, consolidation, and expansion in the next decade. New databases, linked with much more sophisticated data management systems, will allow new strategies for (much more efficient) analysis. Newer information technology capacities have supported various trial and registry databases (eg, Redcap,33 I2B234) and have much promise for pediatric health services research.
Advocacy
The previous sections provide some guidance for the content of advocacy for children’s health. Academic generalists provide the bulk of care for high risk children and youth in the United States and have special knowledge of their needs. We also have special expertise in a wide variety of issues from educating pediatric professionals to abuse/neglect, development and behavior, environmental risks, chronic illness, prevention, and epidemiology. All of these issues remain vital in the coming
Summary
Children, youth, and families face a series of new trends that will affect their health and well-being. Dramatic growth in diversity among children and families has major implications for program development and research into ways to improve health while diminishing disparities. Accompanying changes in the sociodemographic makeup of US children, the nation is experiencing watershed changes in health care delivery, information technology, and quality measurement, all of which provide major
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The authors have no conflicts of interest to disclose.