Utilization of Child Psychiatry Consultation Embedded in Primary Care for an Urban, Latino Population

被引:2
|
作者
Spencer, Andrea E. [1 ,2 ,3 ,4 ,5 ]
Chiang, Cindy [4 ]
Plasencia, Natalie [4 ]
Biederman, Joseph [4 ,5 ]
Sun, Ying [1 ,6 ]
Gebara, Carolina [4 ]
Jellinek, Michael [5 ]
Murphy, J. Michael [4 ,5 ]
Zima, Bonnie T. [7 ]
机构
[1] Boston Med Ctr, Dept Psychiat, Doctors Off Bldg 909,720 Harrison Ave, Boston, MA 02118 USA
[2] Boston Univ, Sch Med, Boston, MA 02215 USA
[3] MGH Chelsea HealthCare Ctr, Boston, MA USA
[4] Massachusetts Gen Hosp, Dept Psychiat, Boston, MA 02114 USA
[5] Harvard Med Sch, Dept Psychiat, Boston, MA 02115 USA
[6] Boston Univ, Sch Publ Hlth, Boston, MA 02215 USA
[7] Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Los Angeles, CA 90024 USA
关键词
Pediatrics; psychiatry; child psychiatry; integrated care; disparity; access; primary care; Latino; minority; MENTAL-HEALTH-CARE; ATTENTION-DEFICIT/HYPERACTIVITY DISORDER; COLLABORATIVE CARE; BEHAVIORAL HEALTH; COMMUNITY-HEALTH; MODEL; DISPARITIES; INSURANCE; SERVICES; OUTCOMES;
D O I
10.1353/hpu.2019.0047
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective. In a novel model of embedded primary care child psychiatry serving an urban Latino population, we examined determinants of successful referral and relationship between clinical need and service intensity. Methods. We conducted a chart review of referred patients from July 2013-March 2015. We used multiple logistic regressions controlling for confounders to identify determinants of successful referral. We examined the relationship between service intensity and clinical need using Poisson regression, adjusting for exposure time, age, sex, ethnicity, and language. Results. Seventy-four percent of patients completed an evaluation. Younger children (p=.0397) and those with a history of therapy (p=.0077) were more likely to make initial contact. The markers of clinical need included PSC-35 Global Scores (p=.0027) and number of psychiatric diagnoses (p=.0178) predicted number of visits. Conclusions. Our findings support early referral to improve engagement, and provide initial evidence that embedded child psychiatry consultation is feasible and may increase access to care.
引用
收藏
页码:637 / 652
页数:16
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