TY - JOUR
AU - S. P. Martin-Herz
AU - C. A. Buysse
AU - A. DeBattista
AU - H. M. Feldman
A1 - 
AB - OBJECTIVE: We developed a colocation "Rapid Developmental Evaluation" (RDE) model for Developmental-Behavioral Pediatrics (DBP) to evaluate young children for developmental concerns raised during routine developmental surveillance and screening in a pediatric primary care Federally Qualified Health Center (FQHC). In this low-income patient population, we anticipated that colocation would improve patient access to DBP and decrease time from referral to first developmental evaluation and therapeutic services. METHODS: Children were assessed at the FQHC by a DBP pediatrician, who made recommendations for therapeutic services and further diagnostic evaluations. A retrospective chart review over 27 months (N = 151) investigated dates of referral and visit, primary concern, diagnosis, and referral to tertiary DBP center and associated tertiary DBP center dates of service and diagnoses if appropriate. We surveyed primary care clinicians (PCCs) for satisfaction. RESULTS: The DBP pediatrician recommended that 51% of children be referred to the tertiary DBP center for further diagnostic evaluation or routine DBP follow-up. Average wait from referral to an RDE visit was 57 days compared with 137.3 days for the tertiary DBP center. Children referred from RDE to the tertiary DBP center completed visits at a higher rate (77%) than those referred from other sites (54%). RDE-recommended therapeutic services were initiated for 73% of children by the tertiary visit. Fidelity of diagnosis between RDE and the tertiary DBP center was high, as was PCC satisfaction. CONCLUSION: Colocation of a DBP pediatrician in an FQHC primary care pediatrics program decreased time to first developmental assessment and referral for early intervention services for an at-risk, low-income patient population.
AD - Division of Developmental Medicine, Department of Pediatrics, University of California San Francisco, San Francisco, CA.; Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto CA.; Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto CA.; Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto CA.
BT - Journal of developmental and behavioral pediatrics : JDBP
C5 - Healthcare Disparities
CY - United States
DO - 10.1097/DBP.0000000000000789
JF - Journal of developmental and behavioral pediatrics : JDBP
M1 - Journal Article
N2 - OBJECTIVE: We developed a colocation "Rapid Developmental Evaluation" (RDE) model for Developmental-Behavioral Pediatrics (DBP) to evaluate young children for developmental concerns raised during routine developmental surveillance and screening in a pediatric primary care Federally Qualified Health Center (FQHC). In this low-income patient population, we anticipated that colocation would improve patient access to DBP and decrease time from referral to first developmental evaluation and therapeutic services. METHODS: Children were assessed at the FQHC by a DBP pediatrician, who made recommendations for therapeutic services and further diagnostic evaluations. A retrospective chart review over 27 months (N = 151) investigated dates of referral and visit, primary concern, diagnosis, and referral to tertiary DBP center and associated tertiary DBP center dates of service and diagnoses if appropriate. We surveyed primary care clinicians (PCCs) for satisfaction. RESULTS: The DBP pediatrician recommended that 51% of children be referred to the tertiary DBP center for further diagnostic evaluation or routine DBP follow-up. Average wait from referral to an RDE visit was 57 days compared with 137.3 days for the tertiary DBP center. Children referred from RDE to the tertiary DBP center completed visits at a higher rate (77%) than those referred from other sites (54%). RDE-recommended therapeutic services were initiated for 73% of children by the tertiary visit. Fidelity of diagnosis between RDE and the tertiary DBP center was high, as was PCC satisfaction. CONCLUSION: Colocation of a DBP pediatrician in an FQHC primary care pediatrics program decreased time to first developmental assessment and referral for early intervention services for an at-risk, low-income patient population.
PP - United States
PY - 2020
SN - 1536-7312; 0196-206X
T1 - Colocated Developmental-Behavioral Pediatrics in Primary Care: Improved Outcome Across Settings
T2 - Journal of developmental and behavioral pediatrics : JDBP
TI - Colocated Developmental-Behavioral Pediatrics in Primary Care: Improved Outcome Across Settings
U1 - Healthcare Disparities
U2 - 32108124
U3 - 10.1097/DBP.0000000000000789
VO - 1536-7312; 0196-206X
Y1 - 2020
Y2 - Feb 26
ER -