TY - JOUR KW - Child KW - Child Behavior Disorders/diagnosis/economics KW - Child Behavior/physiology KW - Child Development/classification/physiology KW - Child, Preschool KW - Developmental Disabilities/diagnosis/economics KW - Health Care Costs KW - Humans KW - Infant KW - Infant, Newborn KW - Mass Screening/economics/methods KW - Models, Economic KW - Parents KW - Pediatrics/economics/methods KW - Physician's Practice Patterns/economics KW - Primary Health Care/economics/methods KW - Questionnaires KW - Relative Value Scales AU - D. Dobrez AU - A. L. Sasso AU - J. Holl AU - M. Shalowitz AU - S. Leon AU - P. Budetti A1 - AB - OBJECTIVE: Despite increased recognition of the importance of development and growth of young children, formal developmental and behavioral screening often is not included in general pediatric practice. Barriers to the provision of developmental and behavioral screening are considerable; among them are the need for specialized training and uncertain reimbursement. This article develops a model for estimating the cost of providing pediatric developmental and behavioral screening that can be scaled to reflect a pediatric practice's patient population and choice of screening offered. METHODS: The framework for our scaleable cost model was drawn from work done in estimating the Resource-Based Relative Value Scale (RBRVS). RBRVS provides estimates of the work effort involved in the provision of health care services for individual Current Procedural Terminology codes. The American Academy of Pediatrics has assigned descriptions of pediatric services, including developmental and behavioral screening, to the Current Procedural Terminology codes originally created for adult health care services. The cost of conducting a screen was calculated as a function of the time and staff required and was loaded for practice costs using the RBRVS valuation. The cost of the follow-up consultation was calculated as a function of the time and staff required and the number of relative value units assigned in the RBRVS scale. RESULTS: The practice cost of providing developmental and behavioral screening is driven primarily by the time and staff required to conduct and evaluate the screens. Administration costs are lowest for parent-administered developmental screens ($0 if no assistance is required) and highest ($67) for lengthy, pediatric provider-administered screens, such as the Neonatal Behavioral Assessment Scale. The costs of 3 different groups of developmental and behavioral screening are estimated. The estimated per-member per-month cost per 0- to 3-year-old child ranges from $4 to >$7 in our 3 examples. CONCLUSIONS: Cost remains a significant barrier to greater provision of formal developmental and behavioral screening. Our scaleable cost model may be adjusted for a given practice to account for the overall level of developmental risk. The model also provides an estimate of the time and cost of providing new screening services. This model allows pediatric practices to select the mix of developmental screens most appropriate for their particular patient population at an acceptable cost. BT - Pediatrics C5 - Financing & Sustainability CP - 4 CY - United States IS - 4 JF - Pediatrics N2 - OBJECTIVE: Despite increased recognition of the importance of development and growth of young children, formal developmental and behavioral screening often is not included in general pediatric practice. Barriers to the provision of developmental and behavioral screening are considerable; among them are the need for specialized training and uncertain reimbursement. This article develops a model for estimating the cost of providing pediatric developmental and behavioral screening that can be scaled to reflect a pediatric practice's patient population and choice of screening offered. METHODS: The framework for our scaleable cost model was drawn from work done in estimating the Resource-Based Relative Value Scale (RBRVS). RBRVS provides estimates of the work effort involved in the provision of health care services for individual Current Procedural Terminology codes. The American Academy of Pediatrics has assigned descriptions of pediatric services, including developmental and behavioral screening, to the Current Procedural Terminology codes originally created for adult health care services. The cost of conducting a screen was calculated as a function of the time and staff required and was loaded for practice costs using the RBRVS valuation. The cost of the follow-up consultation was calculated as a function of the time and staff required and the number of relative value units assigned in the RBRVS scale. RESULTS: The practice cost of providing developmental and behavioral screening is driven primarily by the time and staff required to conduct and evaluate the screens. Administration costs are lowest for parent-administered developmental screens ($0 if no assistance is required) and highest ($67) for lengthy, pediatric provider-administered screens, such as the Neonatal Behavioral Assessment Scale. The costs of 3 different groups of developmental and behavioral screening are estimated. The estimated per-member per-month cost per 0- to 3-year-old child ranges from $4 to >$7 in our 3 examples. CONCLUSIONS: Cost remains a significant barrier to greater provision of formal developmental and behavioral screening. Our scaleable cost model may be adjusted for a given practice to account for the overall level of developmental risk. The model also provides an estimate of the time and cost of providing new screening services. This model allows pediatric practices to select the mix of developmental screens most appropriate for their particular patient population at an acceptable cost. PP - United States PY - 2001 SN - 1098-4275; 0031-4005 SP - 913 EP - 922 EP - T1 - Estimating the cost of developmental and behavioral screening of preschool children in general pediatric practice T2 - Pediatrics TI - Estimating the cost of developmental and behavioral screening of preschool children in general pediatric practice U1 - Financing & Sustainability U2 - 11581444 VL - 108 VO - 1098-4275; 0031-4005 Y1 - 2001 ER -