Provider Responses to Positive Developmental Screening: Disparities in Referral Practices?
Provider Responses to Positive Developmental Screening: Disparities in Referral Practices?
复制标题
提供商对积极发育筛查的反应：转诊实践中的差异？
DOI：
10.1097/dbp.0000000000000855
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Miller,JudithS
中科院分区：
文献类型：
--
作者：
Wallis,KateE;DavisRivera,LaurenB;Guthrie,Whitney;Bennett,AmandaE;Mandell,DavidS;Miller,JudithS
目标：指南建议在儿科初级保健中对幼儿的发育问题进行普遍筛查，并对筛查结果呈阳性的儿童尽早转诊至早期干预 (EI)。然而，EI 的参与因儿童种族、民族、语言和性别而异。这项研究评估了转介到 EI 的比率的差异，并估计了与阳性发育筛查之前和之后转诊相关的因素。方法：在实施了普遍发育筛查的大型初级保健网络中就诊的儿童，如果在 16 至 30 个月的健康儿童就诊期间在幼儿福祉调查 (SWYC) 里程碑中筛查结果呈阳性，则将其纳入其中 (n= 7358)。从电子健康记录中提取人口统计数据、筛查结果和转介。结果：在筛查呈阳性的儿童中，17.5% 已加入 EI，39.9% 在筛查呈阳性的就诊期间被转介至 EI； 42.5%没有被推荐。在调整回归中，以下因素与阳性筛查前处于 EI 状态相关：较低的 SWYC 分数以及男性、老年人和白人。以下因素与在 SWYC 阳性就诊期间新转诊至 EI 相关：SWYC 分数较低或收入较低，并且是男性、老年人和黑人种族。结论：研究结果表明，白人儿童更有可能在发育筛查前转诊，非白人儿童更有可能在阳性筛查时转诊，这表明筛查通过增加对来自传统服务不足背景的发育迟缓儿童的转诊来减少差异。
Objectives:Guidelines recommend universal screening for developmental concerns in young children in pediatric primary care, with referral to early intervention (EI) as early as possible for children with a positive screen. However, participation in EI differs by child race, ethnicity, language, and sex. This study evaluated disparities in rates of referral to EI and estimated the factors associated with referral before and immediately after a positive developmental screen.Methods:Children seen in a large primary care network that has implemented universal developmental screening were included if they screened positive on the Survey of Well-being of Young Children (SWYC) Milestones during a 16-to 30-month well-child visit (n= 7358). Demographics, screening results, and referrals were extracted from the electronic health record.Results:Among children who screened positive, 17.5% were already in EI, and 39.9% were referred to EI during the visit with positive screen; 42.5% were not referred. In adjusted regression, the following factors were associated with being in EI before the positive screen: lower SWYC score and being male, older, and White. The following factors were associated with new referral to EI during a visit with positive SWYC: having lower SWYC score or lower income and being male, older, and Black race.Conclusion:The finding that White children were more likely referred before developmental screening and non-White children more likely referred at the time of positive screen suggests that screening decreases disparities by increasing referral for children with developmental delays from traditionally underserved backgrounds.
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影响因子：
8
作者：
Lipkin, Paul H.;Macias, Michelle M.;Levy, Susan E.
通讯作者：
Levy, Susan E.
影响因子：
4.6
作者：
Petterson, SM;Albers, AB
通讯作者：
Albers, AB
DOI：
10.1177/1362361313480277
发表时间：
2014-07
期刊：
Autism : the international journal of research and practice
影响因子：
--
作者：
Daniels AM;Mandell DS
通讯作者：
Mandell DS
影响因子：
13.8
作者：
McManus, Beth M.;Richardson, Zachary;Morrato, Elaine H.
通讯作者：
Morrato, Elaine H.
影响因子：
--
作者：
Glascoe, FP
通讯作者：
Glascoe, FP