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Book Review
Children's Health Care: Issues for the Year 2000 and Beyond
Gullotta/Hampton/Adams/Ryan and Weissberg
ISBN: 0-761919-32-5 1999 Sage Publications
Allison Williams
Clinical Nurse, Community Child Health Service,
Royal Children's Hospital and Health Service District, Fortitude Valley QLD
Children's Health Care: Issues for the Year 2000 and Beyond is a title sure to catch the attention of all working in the area of child health in Australia, but this book is focused on the American Health System. It is one of a series of "Issues in Children's and Families Lives". It claims to 'focus attention on the pressing social problems facing children and their families today', but falls short of the expectation the title evokes.
Each chapter has different authors. The book is generally not relevant in the Australian context, unless to policy makers who may be interested in the evolution of the American health Care System.
In chapter 1, there is interesting discussion about Public health Issues related to paediatricians in the first part of the Twentieth Century and how this created changes in the way paediatric care was delivered. Also, how this foreshadowed the future direction of health care financing.
Chapter 2 describes the Medicaid Program at length and its relationship to Social Security and Welfare payments. This chapter shows the complexity of the USA Health Insurance System. The author of this chapter also discusses managed care, a word we are now increasingly hearing in Australia.
In Chapter 3, the authors have written about Mental Health care coverage for children and families, again this looks at services in the USA. A historical perspective is provided. The cost saving and normalising of keeping children at home is discussed. Medicaid and managed care are also issues to the authors of this chapter.
School- based health and social service centres is the topic of Chapter 4. The school-based programs are described. The author cites evaluation of many programs already implemented in the USA. There is also discussion on the assertion that when health services are made accessible that achievement and graduation rates should increase.
Chapter 5 From Individual to Social Change: Current and Future Directions of Health Interventions. This is a short chapter which places emphasis on a Public health model, focusing on health behaviour interactions change and legislation, it does not specifically focus on children's health.
The future of psychotherapy in a changing health care systems the topic of Chapter 6, again this chapter does not appear to be specifically child/adolescent focused, but includes the issues of the psychotherapy in the future.
Chapter 7 focuses on Behavioural Medicine: The Cost Effectiveness of Primary Prevention. A good comparative study analysis between the Public health and the Medical Model is made. There is discussion by the author of the effects of managed care and the lack of community based health service systems in the USA.
The final chapter is optimistic in the contribution of child and adolescent service systems known as System of Care Models into this century. It addresses the needs of children with significant mental health difficulties and provides models, which describe a multilevel and multidisciplinary approach.
Despite the focus on the American health system, this book is useful reading for Australian policy makers and those interested in managed care programs, as well as Public Health Practitioners.
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