Group well-child care: an analysis of cost

Clin Pediatr (Phila). 2014 Apr;53(4):387-94. doi: 10.1177/0009922813512418. Epub 2013 Dec 10.

Abstract

Objective: To determine if group well-child visits (WCV) can be cost neutral compared with individual WCV by varying health care providers, group size, and physician salary.

Method: We created 6 economic models to evaluate the costs of WCV: 3 for individual WCV delivered by (1) advanced practice registered nurse (APRN), (2) resident, and (3) attending and 3 for group WCV delivered by (4) APRN with a nurse and social worker; (5) resident with an attending, nurse, and child life specialist; and (6)attending with a nurse. For group WCV, we performed sensitivity analyses on group size and duration of provider participation.

Results: We achieved cost-neutrality at 4 families in the APRN group WCV model; at 3, 4, 5, and 6 families in the resident model with 30, 45, 60, and 90 minutes of attending supervision, respectively; and at 4 and 5 families in the low and high attending salary model, respectively.

Conclusion: Group WCV can be delivered in a cost-neutral manner by optimizing group size and provider participation.

Keywords: cost analysis; group well-child care; primary care; well-child care; well-child visit.

MeSH terms

  • Advanced Practice Nursing / economics
  • Child Health Services / economics*
  • Child Welfare / economics*
  • Child, Preschool
  • Costs and Cost Analysis
  • Humans
  • Infant
  • Internship and Residency / economics
  • Models, Organizational
  • Nurses / economics*
  • Physicians / economics*
  • Primary Health Care / economics*
  • Social Work / economics*