Specialty Referral Communication and Completion in the Community Health Center Setting

Zuckerman, Katharine E.; Nelson, Kerrie P.; Bryant, Tara K.; Hobrecker, Karin; Perrin, James M.; Donelan, Karen

doi:10.1016/j.acap.2011.03.002

Cited by 22 publications

(21 citation statements)

References 17 publications

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“…Minority parents have been shown to follow through with referrals to specialists at a lower rate than Caucasian parents (Zuckerman et al 2011), a difference that has also been established in regards to autism referral attendance (Kalb et al 2012). Minority parents may face more socioeconomic, scheduling, and transportation barriers to visit specialists (Broder-Fingert et al 2013;Kalb et al 2012).…”

Section: Discussionmentioning

confidence: 96%

Predictors of Age of Diagnosis for Children with Autism Spectrum Disorder: The Role of a Consistent Source of Medical Care, Race, and Condition Severity

Emerson

Morrell

Neece

2015

J Autism Dev Disord

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Having a consistent source of medical care may facilitate diagnosis of autism spectrum disorders (ASD). This study examined predictors of age of ASD diagnosis using data from the 2011-2012 National Survey of Children's Health. Using multiple linear regression analysis, age of diagnosis was predicted by race, ASD severity, having a consistent source of care (CSC), and the interaction between these variables after controlling for birth cohort, birth order, poverty level, parental education, and health insurance. While African American children were diagnosed earlier than Caucasians, this effect was moderated by ASD severity and CSC. Having a CSC predicted earlier diagnosis for Caucasian but not African American children. Both physician and parent behaviors may contribute to diagnostic delays in minority children.

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Section: Discussionmentioning

confidence: 96%

Predictors of Age of Diagnosis for Children with Autism Spectrum Disorder: The Role of a Consistent Source of Medical Care, Race, and Condition Severity

Emerson

Morrell

Neece

2015

J Autism Dev Disord

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“…Previous reports from this study have described the relationships of patient demographic factors, referral characteristics, and provider/parent communication on specialty referral completion. 7,9 …”

Section: Methodsmentioning

confidence: 99%

“…Studies have shown that patient demographic factors, referral characteristics, and parent/provider communication may contribute to high rates of incomplete referral. 7,9 …”

mentioning

confidence: 99%

Barriers to Specialty Care and Specialty Referral Completion in the Community Health Center Setting

Zuckerman

Perrin

Hobrecker

et al. 2013

The Journal of Pediatrics

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Objective To assess the frequency of barriers to specialty care and to assess which barriers are associated with an incomplete specialty referral (not attending a specialty visit when referred by a primary care provider) among children seen in community health centers. Study design Two months after their child’s specialty referral, 341 parents completed telephone surveys assessing whether a specialty visit was completed and whether they experienced any of 10 barriers to care. Family/community barriers included difficulty leaving work, obtaining childcare, obtaining transportation, and inadequate insurance. Health care system barriers included getting appointments quickly, understanding doctors and nurses, communicating with doctors’ offices, locating offices, accessing interpreters, and inconvenient office hours. We calculated barrier frequency and total barriers experienced. Using logistic regression, we assessed which barriers were associated with incomplete referral, and whether experiencing ≥4 barriers was associated with incomplete referral. Results A total of 22.9% of families experienced incomplete referral. 42.0% of families encountered 1 or more barriers. The most frequent barriers were difficulty leaving work, obtaining childcare, and obtaining transportation. On multivariate analysis, difficulty getting appointments quickly, difficulty finding doctors’ offices, and inconvenient office hours were associated with incomplete referral. Families experiencing ≥4 barriers were more likely than those experiencing ≤3 barriers to have incomplete referral. Conclusion Barriers to specialty care were common and associated with incomplete referral. Families experiencing many barriers had greater risk of incomplete referral. Improving family/community factors may increase satisfaction with specialty care; however, improving health system factors may be the best way to reduce incomplete referrals.

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“…30 Finally, nonwhite and white children may present with similar complaints with similar rates of referral, but nonwhite children may not follow-up with referrals at the same rate as white children. Zuckerman et al 31 showed that divergent beliefs between parents and providers regarding the importance of subspecialty referrals can lead to poor subspecialty follow-up by patients. Parents of nonwhite children with ASD may be less likely to complete a referral due to certain beliefs concerning the seriousness of the referral.…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Differences in Subspecialty Service Use by Children With Autism

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Racial and ethnic differences exist in age at diagnosis and early access to mental and behavioral health services among children with autism spectrum disorders (ASDs). ASDs are also associated with increased rates of other medical comorbidities that may require specialty care.WHAT THIS STUDY ADDS: Significant racial and ethnic differences in use of specialty care and specialty procedures exist among children with documented ASD. abstract OBJECTIVE: To describe racial differences in use of specialty care among children with autism spectrum disorder. METHODS:We identified patients ages 2 to 21 years with an International Classification of Diseases, Ninth Revision code of autism (299.0) seen from 2000 to 2011 at a major academic health center by using a research patient data repository and determined rates of specialty provider visits and procedures by race. We then used logistic regression to determine the associations of rates of subspecialty visits and procedures with race and ethnicity, controlling for gender, age, and payer type. RESULTS:We identified 3615 patients (2935 white, 243 Hispanic, 188 African American, and 249 other). The most striking differences were in use of gastroenterology (GI)/nutrition services. Nonwhite children were less likely to use GI/nutrition specialty providers (African American, odds ratio = 0. CONCLUSIONS:We found racial and ethnic differences among children diagnosed with autism in use of care and procedures. Possible explanations for these findings include differences in presentation, referral rates, or referral follow through. Pediatrics 2013;132:94-100

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Specialty Referral Communication and Completion in the Community Health Center Setting

Cited by 22 publications

References 17 publications

Predictors of Age of Diagnosis for Children with Autism Spectrum Disorder: The Role of a Consistent Source of Medical Care, Race, and Condition Severity

Predictors of Age of Diagnosis for Children with Autism Spectrum Disorder: The Role of a Consistent Source of Medical Care, Race, and Condition Severity

Barriers to Specialty Care and Specialty Referral Completion in the Community Health Center Setting

Racial and Ethnic Differences in Subspecialty Service Use by Children With Autism

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