Integrated Behavioral Health in Pediatric Primary Care: Rates of Consultation Requests and Treatment Duration.
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| Title: | Integrated Behavioral Health in Pediatric Primary Care: Rates of Consultation Requests and Treatment Duration. |
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| Authors: | Okoroji, Chimereodo1,2 (AUTHOR) chimereodo.okoroji@cchmc.org, Mack Kolsky, Rachel3,4 (AUTHOR), Williamson, Ariel A.5,6 (AUTHOR), Mautone, Jennifer A.5,6 (AUTHOR) |
| Source: | Child & Youth Care Forum. Jun2024, Vol. 53 Issue 3, p741-756. 16p. |
| Subject Terms: | *Attention-deficit hyperactivity disorder, *Mental health services, *Autism, *Retrospective studies, *Anxiety, Early medical intervention, Research funding, Primary health care, Logistic regression analysis, Treatment duration, Descriptive statistics, Pediatrics, Sociodemographic factors, Health equity, Integrated health care delivery, Medical referrals |
| Geographic Terms: | New England |
| Abstract: | Background: Integrated primary care (IPC) can address prevalent behavioral health concerns identified in pediatric office visits, but research on IPC consultation patterns is limited. Objective: This study investigated variation in consultation rates across presenting problems, patient sociodemographic factors, and IPC treatment duration. Method: Retrospective electronic health record data were extracted for 970 patients seen in 12 pediatric primary care sites and for whom behavioral health consultation was requested between June 2018 and December 2019. Logistic regressions were used to examine associations between sociodemographic variables, consultation reasons, and IPC visit type. We used multiple linear regression to assess the association between consultation reason and treatment duration. Results: Anxiety (36.2%) and disruptive behavior (29.7%) were the most common consultation reasons. Consultation requests for internalizing (anxiety, mood) problems were more prevalent in school-aged children and adolescents, whereas consultations for disruptive behavior (tantrums) and health-related issues (toileting, sleep concerns) were common in early childhood. Girls were less likely to receive consultation requests for attention deficit/hyperactivity disorder (ADHD) and autism/developmental concerns compared to boys, but more likely to receive consultation for internalizing problems. Consultation requests varied by patient race, ethnicity, visit type, and insurance type. Treatment duration after consultation was longer among patients with consultation requests for ADHD and for depression/mood concerns. Conclusions: Age-related behavioral health consultation patterns in IPC conform with expected developmental trends; however, sociodemographic findings suggest opportunities for enhancing care. Additional research is needed on IPC consultation given its promise for early identification, prevention, and treatment of pediatric mental health concerns. [ABSTRACT FROM AUTHOR] |
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| Database: | Education Research Complete |
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| Abstract: | Background: Integrated primary care (IPC) can address prevalent behavioral health concerns identified in pediatric office visits, but research on IPC consultation patterns is limited. Objective: This study investigated variation in consultation rates across presenting problems, patient sociodemographic factors, and IPC treatment duration. Method: Retrospective electronic health record data were extracted for 970 patients seen in 12 pediatric primary care sites and for whom behavioral health consultation was requested between June 2018 and December 2019. Logistic regressions were used to examine associations between sociodemographic variables, consultation reasons, and IPC visit type. We used multiple linear regression to assess the association between consultation reason and treatment duration. Results: Anxiety (36.2%) and disruptive behavior (29.7%) were the most common consultation reasons. Consultation requests for internalizing (anxiety, mood) problems were more prevalent in school-aged children and adolescents, whereas consultations for disruptive behavior (tantrums) and health-related issues (toileting, sleep concerns) were common in early childhood. Girls were less likely to receive consultation requests for attention deficit/hyperactivity disorder (ADHD) and autism/developmental concerns compared to boys, but more likely to receive consultation for internalizing problems. Consultation requests varied by patient race, ethnicity, visit type, and insurance type. Treatment duration after consultation was longer among patients with consultation requests for ADHD and for depression/mood concerns. Conclusions: Age-related behavioral health consultation patterns in IPC conform with expected developmental trends; however, sociodemographic findings suggest opportunities for enhancing care. Additional research is needed on IPC consultation given its promise for early identification, prevention, and treatment of pediatric mental health concerns. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 10531890 |
| DOI: | 10.1007/s10566-023-09769-2 |
