Referrals to Developmental Pediatrics
What is the Nature of Referrals to Outpatient Services at DBPNet sites at Academic Medical Centers?
Context: Developmental-Behavioral Pediatrics (DBP) is a relatively new pediatric subspecialty recognized with board certification in 2002. Developmental and behavioral problems are common and the disorders are often included in the scope of practice of several other disciplines such as psychology, pediatric neurology and child and adolescent psychiatry. These factors have contributed to confusion for primary care providers, sub-specialty colleagues, families, and payers as to the scope of practice of DBP. The only two post-certification studies focused on the “business” of practice not on the patient populations evaluated by DBP. A newly formed 12-stie research consortium, the Developmental-Behavioral Pediatrics Research Network (DBPNet) provides an opportunity to describe the referral population and practice patterns in a national network of DBP programs.
Objectives: The primary aims of this study are to describe the chief concerns, the characteristics of the assessment, and the time and resources involved in the evaluation patterns of a DBP assessment. Specific objectives include: 1) Describe the referral population, the reason for referral, the assessment, initial diagnoses, and recommendations for children referred for DBP consultation at academic medical centers participating in the DBPNet and 2) quantify the variability of time and resources devoted to initial DBP consultation by referral question and patient characteristics in academic medical centers participating in DBPNet. An ancillary objective is to describe diagnoses given to children referred for evaluation of ADHD or ASD, but not found to have these conditions.
Study Design: This is a prospective descriptive study of the clinical practices of DB pediatricians at DBPNet sites.
Setting/Participants: Attending physicians in all of the 12 DBPNet sites who are board certified or board eligible in DB pediatrics or neurodevelopmental disabilities will be eligible to participate.
Study Interventions and Measures: The main outcome measures will be a provider survey and the new patient scope of practice survey completed by the DB pediatrician. The provider survey will describe physician demographics and clinical interests, settings, time, and numbers of patients evaluated. The scope of practice survey will include patient demographics, reason for referral, assessment elements, growth descriptors, diagnoses, recommendations, and time spent for this initial visit.