General and subspecialist pediatrician perspectives on barriers and strategies for referral: a latent profile analysis.
General and subspecialist pediatrician perspectives on barriers and strategies for referral: a latent profile analysis.
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DOI：
10.1186/s12887-023-04400-8
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发表时间：
2023-11-18
期刊：
影响因子：
2.4
通讯作者：
Ray, Kristin N.
中科院分区：
文献类型：
--
作者：
Bohnhoff, James C.;Guyon-Harris, Katherine;Schweiberger, Kelsey;Ray, Kristin N.
需要儿科专科护理的儿童可能会遇到多种障碍，已经提出了多种战略来改善获得机会。这项研究的目的是描述普通儿科医生和专科儿科医生对专科护理障碍的看法，以及改善专科就医机会的策略的价值。我们在2020年5月和6月对全国1680名普通儿科医生和儿科专科医生进行了调查，内容涉及专科护理的11个障碍和改善获得专科护理的9项战略，这些都是从最近的文献中挑选出来的。使用潜在概况分析，受访者根据他们认为每个障碍影响获得专科护理的程度进行分组。使用卡方检验，我们比较了基于受访者特征和改善访问策略的视角的概况。有效率为17%。在已完成并符合纳入条件的263份答复中，最常被描述为“主要问题”的障碍是等待时间(57%)、缺乏专科专家(45%)和难以安排(41%)。受访者被分为4类：“广泛关注”、“专科医生可用性关注”、“临床医生沟通关注”和“很少关注”。这些资料因受访专业(p <； .001，内科专科医生在“临床医生沟通”简档中占多数，精神科医生在“专科医生可用性”简档中占多数，外科医生在“少数关注事项”简档中占多数)和受访者的典型预约等待时间(p <； .001，内科医生在“专科医生可用情况”简档中占最长的等候时间)而有显著差异。我们在临床医生关于亚专科护理障碍的观点中发现了特定的概况，这与旨在克服这些障碍的战略的观点相关。这些结果表明，旨在改善专科可获得性的卫生系统应该首先确定特定于当地临床医生的障碍和偏好。
Children in need of pediatric subspecialty care may encounter multiple barriers, and multiple strategies have been suggested to improve access. The purpose of this study was to describe the perceptions of general and subspecialty pediatric physicians regarding barriers to subspecialty care and the value of strategies to improve subspecialty access. We surveyed a national sample of 1680 general pediatricians and pediatric subspecialists in May and June 2020 regarding 11 barriers to subspecialty care and 9 strategies to improve access to subspecialty care, selected from recent literature. Using latent profile analysis, respondents were grouped according to the degree to which they believed each of the barriers impacted access to subspecialty care. Using chi-squared tests, we compared the profiles based on respondent characteristics and perspectives on strategies to improve access. The response rate was 17%. In 263 responses completed and eligible for inclusion, the barriers most frequently described as “major problems” were wait times (57%), lack of subspecialists (45%) and difficulty scheduling (41%). Respondents were classified into 4 profiles: “Broad concerns,” “Subspecialist availability concerns,” “Clinician communication concerns,” and “Few concerns.” These profiles varied significantly by respondent specialty (p < .001, with medical subspecialists overrepresented in the “Clinician communication” profile, psychiatrists in the “subspecialist availability” profile, and surgeons in the “few concerns” profile); and by respondents’ typical wait time for appointments (p < .001, with physicians with the longest wait times overrepresented in the “subspecialist availability” profile). We found specific profiles in clinician views regarding barriers to subspecialty care which were associated with perspectives on strategies aimed at overcoming these barriers. These results suggest that health systems aiming to improve subspecialty access should first identify the barriers and preferences specific to local clinicians.
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影响因子：
3.7
作者：
Lai L;Liddy C;Keely E;Afkham A;Kurzawa J;Abdeen N;Audcent T;Bromwich M;Brophy J;Carsen S;Fournier A;Fraser-Roberts L;Gandy H;Hui C;Johnston D;Keely K;Kontio K;Lamontagne C;Major N;O'Connor M;Radhakrishnan D;Reisman J;Robb M;Samson L;Sell E;Splinter W;van Stralen J;Venkateswaran S;Murto K
通讯作者：
Murto K
影响因子：
3.1
作者：
Ray, Kristin N.;Ashcraft, Laura Ellen;Miller, Elizabeth
通讯作者：
Miller, Elizabeth
影响因子：
8
作者：
Reeder, BM;Lyne, ED;Cucos, DR
通讯作者：
Cucos, DR
DOI：
10.1016/j.ijporl.2018.06.036
发表时间：
2018-10-01
影响因子：
1.5
作者：
Shah-Becker, Shivani;Carr, Michele M.
通讯作者：
Carr, Michele M.
影响因子：
14.2
作者：
Schatz, M;Cook, EF;Petitti, D
通讯作者：
Petitti, D