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PEDIATRICS Vol. 101 No. 4 Supplement April 1998, pp. 746-752

Child Health Care in Changing Times

Received Nov 6, 1997; accepted Nov 11, 1997.

Laurel K. Leslie*, Rebecca SarahDagger , and Judith S. PalfreyDagger

From * Children's Hospital, San Diego; Department of Pediatrics, University of California at San Diego; and the Dagger  Division of General Pediatrics, Children's Hospital, Boston, Massachusetts.

Unprecedented transformations in the financing and organization of child health care are driving change in the practice of pediatrics at a remarkably fast pace. The health care needs of children also are evolving, reflecting changing disease patterns, new technologies, and shifting socioeconomic and demographic characteristics of children and families. Changes in the financing and organization of child health services catalyzed by managed care and legislative initiatives need to be responded to proactively by the pediatric community. Yet, the anticipated health care needs of children also must be addressed as models for both pediatric training and practice in the future are developed. This article summarizes briefly these changes in health care services and in child health needs, addresses training implications, and discusses several initiatives the pediatric community is undertaking to develop guidelines for training pediatricians for the 21st century.

Key words: child health status, health care delivery.


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