NATIONAL SURVEY OF EARLY CHILDHOOD HEALTH: PARENT CONCERNS, CONTENT, AND QUALITY OF CARE Neal Halfon, Lynn M. Olson, Moira Inkelas, Miles Hochstein, Michael Kogan, Christina D. Bethell, Stephen J. Blumberg Pediatrics, UCLA, Los Angeles, CA; Public Health, UCLA, Los Angeles, CA; American Academy of Pediatrics, Elk Grove Village, CA; Maternal and Child Health Bureau, HRSA, Rockville, MD; FACCT - The Foundation for Accountability, Portland, OR; NCHS, Hyattsville, MD

BACKGROUND: Despite growing appreciation of the importance of early childhood for later health and developmental outcomes, there are few national data on the content or quality of routine health services for young children. The National Survey of Early Childhood Health (NSECH) fills this information void with descriptive health services data about children under age three.

OBJECTIVE: To describe the health and developmental needs of young children, and the content and quality of their health care.

DESIGN/METHODS: The NSECH is a telephone survey of 2,068 parents of children age 4 to 35 months, based on the National Immunization Survey (NIS) sampling frame and with oversampling for Hispanic and Black children, that profiles content and quality of health care for children. The NSECH was constructed from other surveys including the NHIS, the Promoting Healthy Development Survey, the Commonwealth Survey of Parents with Young Children, and clinical tools such as the Parent Evaluation of Developmental Status (PEDS). Key findings from this new survey are reported.

RESULTS: Most young children (85%) are in excellent or very good health. However, many parents report concerns about their child?s development, such as behavior (48%), language (45%), emotional well being (42%), and getting along with others (41%). While parents report receiving anticipatory guidance about standard recommended topics ( e.g. feeding and nutrition), fewer parents discuss child care (33%), toilet training (36%), and guidance and discipline (44%). A large proportion of parents who were not advised on these topics say that guidance would have been helpful. While most children have a regular place for well child care, only 46% of children have a regular well child clinician. Satisfaction is related to both content of care, and ratings of provider communication. There are disparities in concerns, content of care, and satisfaction based on child and family characteristics, and health care setting.

CONCLUSIONS: The NSECH provides important insight into patterns and disparities in parent concerns, content and quality of care, and missed opportunities to provide essential, desired preventive health care.