Autism Spectrum Disorder Screening in Primary Care
Autism Spectrum Disorder Screening in Primary Care
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DOI：
10.1097/dbp.0b013e3182040aea
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发表时间：
2011-01-01
影响因子：
2.4
通讯作者：
Blood-Siegfried, Jane E.
中科院分区：
文献类型：
--
作者：
Gura, Georgette F.;Champagne, Mary T.;Blood-Siegfried, Jane E.
目的：在美国，每110名儿童中就有一名患有自闭症谱系障碍（ASD）。早期识别和早期干预已被证明可以改善ASD儿童的预后。虽然推荐，但在18和24个月大时进行常规ASD筛查在实践中尚未广泛采用。这项质量改进研究探讨了私人初级保健实践是否可以克服筛查障碍，并使用幼儿自闭症改良清单（TM）实施推荐的普遍ASD筛查实践。方法：在创新扩散循证概念模型的指导下，开发了使用幼儿自闭症改良检查表（TM）的实践变化。对99例受试者进行了回顾性病历审查，以评估筛查保真度和成本。结果：在7个月的时间内达到了91%的总体筛查保真度。该诊所的筛查费用平均每月22.78美元。这被平均每月38.76美元的收入所抵消。结论：这些研究结果表明，低成本的普遍筛查可以在初级保健时，从组织的角度来解决。
Objectives: One in 110 children in the United States has autism spectrum disorder (ASD). Early identification and early intervention have been shown to improve outcomes for children with ASD. Although recommended, routine ASD screening at 18 and 24 months of age has not been widely adopted in practice. This quality improvement study examined whether a private primary care practice could overcome screening barriers and implement the recommended universal ASD screening practice using the Modified Checklist for Autism in Toddlers (TM). Method: Guided by the Diffusion of Innovations evidence-based conceptual model, a practice change using the Modified Checklist for Autism in Toddlers (TM) was developed. A retrospective chart review of 99 subjects was done to evaluate screening fidelity and cost. Results: An overall screening fidelity of 91% was achieved over a 7-month period. The cost of screening to the practice averaged $22.78 per month. This was offset by an average of $38.76 of revenue per month. Conclusion: These findings suggest that low-cost universal screening can be implemented in primary care when addressed from an organizational perspective.