The epidemiology of community paediatric outpatient referrals 2006

Thompson, E.; Bhrolchain, Cliona Ni

doi:10.1111/j.1365-2214.2011.01348.x

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…Paediatricians identify barriers to undertaking rural practice as increased workload, longer working hours, social isolation, insufficient financial incentives and an increasing trend towards subspecialisation 4 . Despite the smaller population base in rural communities, there is a demonstrated need for paediatric services, with our previous work finding the referral rate for the initial year of this rural paediatric service was 31.6 per 1000, 6 which is significantly higher than previously reported referral rates 7–9 …”

Section: Introductionmentioning

confidence: 80%

“…This study aimed to build on our previous work that identified the referral and triage patterns during the initial year of the service by describing the types of problems diagnosed at the initial appointment and associated outcomes. Collection and analysis of this data is essential for health service planning, facilitating the identification of areas of need within specific communities to support contextualised delivery of paediatric health care 1,8 . Improving the integration and coordination of the finite paediatric services in rural communities has been deemed imperative as there are a myriad of influences on children's development that no paediatric service in isolation can effectively manage 1…”

Section: Introductionmentioning

confidence: 99%

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If you build it who will come? Case mix data of a new rural paediatric outpatient clinic

Beattie

Baade²,

Fuller

2023

Australian J Rural Health

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IntroductionThere is limited current evidence describing the case mix data of rural paediatric outpatient clinics. Collection and analysis of this data is essential for health service planning, facilitating the identification of areas of need within specific communities to support contextualised delivery of paediatric health care.ObjectiveTo describe the case mix of patients seen during the initial 12 months of a rural paediatric service, providing evidence to inform rural health service planning.DesignA retrospective cohort study.ResultsThere were 149 initial consultations during the study period. Behavioural/developmental problems were found in 71.8% of patients and physical problems were present in 64.4% of patients. This resulted in 38.9% of patients having a combination of problem types. 42.9% of patients were referred to or already accessing allied health services, while 20% were accessing specialised paediatric support services such as the National Disability Insurance Scheme and child protection services. Investigations were ordered for 45% of patients, with medications prescribed in 43% of cases. Only 5.4% of patients were discharged after their initial appointment. There were significant differences in problems identified on the referral compared to at the initial appointment demonstrating the value of this service to a rural community.ConclusionThe case mix data illustrates a rural paediatric cohort with a complex and chronic burden of disease especially in terms of behavioural and developmental problems. These findings add to the literature on rural paediatric patient care and demonstrate the value of an embedded paediatric service in a medium sized rural town.

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Section: Introductionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

If you build it who will come? Case mix data of a new rural paediatric outpatient clinic

Beattie

Baade²,

Fuller

2023

Australian J Rural Health

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“…The Australian health-care system, similar to other countries, is continuously trying to manage childhood conditions within a primary health-care setting. 21,22 The continual education of primary care providers to support children's complex developmental needs, both prior to and following specialist care, is a contemporary topic of discussion. 23 Results of this study highlight this need by the proportion of children who did not receive a diagnosis and were discharged back to GP care following AAHP input.…”

Section: Discussionmentioning

confidence: 99%

Reducing time between referral and diagnosis in paediatric outpatient neurodevelopmental and behavioural clinics

Creen

Kennedy‐Behr

Gee

et al. 2020

J Paediatrics Child Health

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Aim This study investigated the impact of a transdisciplinary advanced allied health practitioner (AAHP) in a public hospital general paediatric outpatient department for children referred for concerns with neurodevelopment, learning and/or behaviour. It was hypothesised that time from referral to initial consultation and diagnosis was reduced for children initially assessed by AAHP. It was also hypothesised that children seen by AAHP were less likely to require a medical specialist appointment. Methods De‐identifiable data were gathered from hospital records both retrospectively and prospectively for each group. Data were collected from: 75 children who attended a medical consultation only clinic in 2014; 75 children who attended an AAHP clinic and a medical officer in 2014 and 75 children who attended an AAHP clinic and a medical officer 2 years after establishment in 2016/2017. Results On average, 52% children were managed independently by the AAHP. Wait time from referral to consultation significantly decreased from 169 days to 48 days. Similarly, time from referral to diagnosis significantly reduced by almost a half, from 57.2 to 30.59 weeks. Conclusion This study provides preliminary evidence that utilisation of transdisciplinary AAHPs in general paediatric outpatient departments may reduce waitlists, reduce amount of medical specialist appointments required and provide earlier diagnosis for children with neurodevelopmental, behavioural and/or learning difficulties.

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“…While all of these studies demonstrate a clear association between peer reinforcement and increased deviant behavior, the limited work on elementary school-age children is surprising. Further examination of peer reinforcement for deviant behavior is vital in this population, as elementary school is commonly a time when children are referred for mental health services, most often for behavior problems (Thompson & Bhrolchain, 2011). …”

Section: Effects Of Behavior Modification and Stimulant Medication Onmentioning

confidence: 99%

Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-only, ADHD and conduct problems, and controls.

Helseth

Waschbusch

Gnagy

et al. 2015

Journal of Consulting and Clinical Psychology

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Objective This study compared the unique and combined effects of evidence-based treatments for ADHD —stimulant medication and behavior modification—on children’s rates of reinforcement for deviant peer behavior (RDPB). Method Using a within-subjects design, 222 elementary school-age children attending a summer treatment program, including 151 children with ADHD (127 male), with and without comorbid conduct problems, and 71 control children (57 male), received varying combinations of behavior modification (no, low-intensity, and high-intensity) and methylphenidate (placebo, 0.15 mg/kg, 0.30 mg/kg, and 0.60 mg/kg). RDPB was measured through direct observation and compared across all behavior modification and medication conditions. Results Children with ADHD reinforced the deviant behavior of their peers at a significantly higher rate than control children in the absence of either intervention. However, that difference largely disappeared in the presence of both behavior modification and medication. Both low and high-intensity behavior modification, as well as medium (0.30 mg/kg) and high (0.60 mg/kg) doses of methylphenidate, significantly reduced the rate of ADHD children’s RDPB to levels similar to the control group. Conclusions Results indicate that although untreated children with ADHD do engage in RDPB at a greater rate than their non-ADHD peers, existing evidence-based interventions can substantially decrease the presence of RDPB, thereby limiting potential iatrogenic effects in group-based treatment settings. Public Health Significance Statement This study found that children with behavior disorders reinforced their peers' deviant behaviors much more than typically developing children. However, behavior modification and medication treatments both reduced reinforcement rates, indicating that peer contagion can easily be managed in group-based treatments for children

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The epidemiology of community paediatric outpatient referrals 2006

Abstract: This population-based study gives a unique insight into the epidemiology of referrals to community paediatricians in the UK in 2006 and how these differ from those recorded in a different UK district in 1998.

Cited by 5 publications

References 7 publications

If you build it who will come? Case mix data of a new rural paediatric outpatient clinic

If you build it who will come? Case mix data of a new rural paediatric outpatient clinic

Reducing time between referral and diagnosis in paediatric outpatient neurodevelopmental and behavioural clinics

Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-only, ADHD and conduct problems, and controls.

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