Access to specialty care in autism spectrum disorders-a pilot study of referral source.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Child Development Disorders, Pervasive/*diagnosis ; Health Services Accessibility/*statistics & numerical data ; Medicine/*statistics & numerical data ; Patient-Centered Care/*statistics & numerical data ; Referral and Consultation/*statistics & numerical data; Adolescent ; Chi-Square Distribution ; Child ; Child Development Disorders, Pervasive/drug therapy ; Child, Preschool ; Female ; Health Services Needs and Demand ; Humans ; Insurance, Health/statistics & numerical data ; Male ; Pilot Projects ; Retrospective Studies ; Young Adult

Background: In the United States, a medical home model has been shown to improve the outcomes for children with special health care needs. As part of this model, primary care physicians provide comprehensive medical care that includes identification of delayed and/or atypical development in children and coordination of care with specialists. However, it is not clear if families of children with Autism Spectrum Disorder (ASD) rely on the medical home model for care of their child to the same extent as families of children with other special health care needs. This study aims to add to the understanding of medical care for children with ASD by examining the referral source for specialty care.
Methods: This retrospective study was accomplished by evaluating parent completed intake data for children with ASD compared to those with other neurological disorders in a single physician Pediatric Neurology Practice at a major urban medical center in Northern New Jersey. To account for referral bias, a similar comparison study was conducted using a multispecialty ASD practice at the same medical center. Parent reported "source of referral" and "reason for the referral" of 189 ASD children and 108 non-ASD neurological disordered children were analyzed.
Results: The specialty evaluations of ASD were predominantly parent initiated. There were significantly less referrals received from primary care physicians for children with ASD compared to children with other neurodevelopmental disorders. Requirement of an insurance referral was not associated with a primary care physician prompted specialty visit.We identified different patterns of referral to our specialty clinics for children with ASD vs. children with other neurolodevelopmental disorders.
Conclusion: The majority of the families of children with ASD evaluated at our autism center did not indicate that a primary care physician initiated the specialty referral. This study suggests that families of children with ASD interface differently with the primary care provider than families of children with other neurological disorders.

Arch Pediatr Adolesc Med. 2007 Apr;161(4):399-405. (PMID: 17404138)
J Autism Dev Disord. 2006 Aug;36(6):807-28. (PMID: 16897404)
J Autism Dev Disord. 2007 Jan;37(1):98-107. (PMID: 17206522)
Pediatrics. 2007 Nov;120(5):1183-215. (PMID: 17967920)
MMWR Surveill Summ. 2009 Dec 18;58(10):1-20. (PMID: 20023608)
BMC Pediatr. 2007 Nov 20;7:37. (PMID: 18021459)
Pediatrics. 2001 May;107(5):E85. (PMID: 11331735)
Lancet. 2009 Nov 7;374(9701):1627-38. (PMID: 19819542)

Date Created: 20110517 Date Completed: 20110929 Latest Revision: 20211020

20221213

PMC3117687

10.1186/1472-6963-11-99

21569571