Association of Care Coordination Experience and Health Services Use with Main Provider Type for Children with Inflammatory Bowel Disease.
Association of Care Coordination Experience and Health Services Use with Main Provider Type for Children with Inflammatory Bowel Disease.
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DOI：
10.1016/j.jpeds.2021.03.013
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Kappelman MD
中科院分区：
文献类型：
--
作者：
deJong NA;Wofford M;Song PH;Kappelman MD
描述IBD儿童家庭的护理协调经验，并比较将初级保健医生（PCP）与胃肠病学家确定为儿童主要提供者的家庭之间的卫生服务使用情况。对2018年期间在儿童医院接受IBD项目护理的6-19岁儿童的护理协调经验和卫生服务使用情况进行了横断面调查。讲英语的父母完成了关于他们孩子的“主要提供者”的家庭护理协调（FECC）调查，并报告了去年的医疗服务。双变量检验和多变量logistic回归探讨了主要提供者的护理协调经验和卫生服务的差异，并对人口统计学和临床变量进行了调整。270名受邀受试者中共有113名（42%）参与。在101名具有完整数据的受试者中，41%确定了PCP的主要提供者。与PCP主要提供者相比，报告GI的患者在16个FECC指标中的5个指标上的表现更高。然而，与GI主要提供者相比，PCP与过去一年任何初级保健服务的使用率较高（调整后比例为94% vs 75%，p=0.01）以及需要时精神卫生服务的使用率较高（95% vs 60%，P <0.01）。IBD相关住院和急诊就诊的需求在两组之间没有差异。IBD儿童可能会经历护理协调质量和重要的非疾病为重点的卫生服务的权衡，基于父母认为谁是主要提供者。需要努力加强家庭、初级和专科护理团队之间的跨团队协调，以提高整体护理质量。
To describe care coordination experience for families of children with IBD and compare use of health services between families who identified a primary care physician (PCP) versus gastroenterologist as a child’s main provider. Cross-sectional survey of care coordination experience and health services use for children 6–19 years old receiving care in the IBD program at a children’s hospital during 2018. English-speaking parents completed the Family Experiences with Coordination of Care (FECC) Survey about their child’s “main provider” and reported past-year health services. Bivariate testing and multivariate logistic regression explored differences in care coordination experience and health services by main provider, adjusted for demographic and clinical variables. A total of 113 of 270 (42%) invited subjects participated. Among 101 subjects with complete data, 41% identified a PCP main provider. Performance on 5 of 16 FECC indicators was higher for patients reporting a GI vs PCP main provider. However, having a PCP vs GI main provider was associated with higher use of any past-year primary care services (adjusted proportion 94% vs 75%, p=0.01) and of mental health services when needed (95% vs 60%, P < .01). Need for IBD-related hospitalization and emergency department visits did not differ between groups. Children with IBD may experience trade-offs in care coordination quality and important, non disease-focused health services based on whom parents perceive as the main provider. Efforts to enhance cross-team coordination among families and primary and specialty care teams are needed to improve overall care quality.
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影响因子：
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作者：
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