RESUMO
OBJECTIVE: To determine the current status of social work presence in pediatric primary care clinics in urban teaching hospitals. DESIGN: Survey instrument mailed to the medical directors of outpatient pediatrics in the major pediatric teaching hospital of approved residency programs in the 100 largest metropolitan areas in the United States. RESULTS: Sixty responses (60%) were received. Eighty percent of practices reported having on-site social work services, with a median of 14,805 annual clinic visits per social work full-time equivalent. Ninety-five percent of respondents considered on-site social work services in pediatric primary care to be important, whereas half of respondents considered social work services "less than adequate" at their site, and most of these felt this inadequacy had led to additional hospital visits or other adverse outcomes. There were no significant associations of reported adequacy of social work services with any characteristics of hospital, practice, or population. CONCLUSION: Pediatric primary care clinicians at teaching hospitals consider on-site social work services to be important, but most report these services are less than adequate in their practices, and for many, adequacy has declined.