自闭症谱系障碍诊断年龄和以患者为中心的医疗之家组成部分。

IF 1.6 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Journal of Clinical Psychology in Medical Settings Pub Date : 2024-08-07 DOI:10.1007/s10880-024-10035-3
C A Limbers, T Zeleznik, G Beuley, A Milliken, E Hernandez, S R Ryan-Pettes
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引用次数: 0

摘要

儿童自闭症谱系障碍(ASD)的早期诊断有利于提供服务并增加通过干预改善功能的机会。以患者为中心的医疗之家(PCMH)是一种强调集中、便捷和协调护理的医疗模式。本研究的目的是在控制相关临床和社会人口因素的前提下,在全国 17 岁及以下 ASD 患儿样本中评估 PCMH 各组成部分与 ASD 诊断年龄之间的关联。本研究是一项横断面观察性研究。参与者是2020年全国儿童健康调查(NSCH)中1,193名患有自闭症儿童的照顾者。在两个回归模型中,以 ASD 诊断年龄为标准变量进行了层次多元线性回归分析。研究了二元复合医疗之家替代变量以及五个医疗之家组成部分(通常的护理来源、私人医生或护士、以家庭为中心的护理、护理协调、能够在需要时获得转介)。在第一项回归分析中,整体 PCMH 代理变量与 ASD 诊断年龄有显著相关性(标准化贝塔系数 = -.08; p
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Age of Autism Spectrum Disorder Diagnosis and Patient-Centered Medical Home Components.

Early diagnosis of autism spectrum disorder (ASD) in children facilitates the provision of services and enhances opportunities for improving functioning via intervention. To date, limited studies have examined whether age of ASD diagnosis is associated with components of care of the patient-centered medical home (PCMH), a model of health care that emphasizes centralized, accessible, and coordinated care. The objective of the current study was to evaluate the associations between components of the PCMH and age of ASD diagnosis while controlling for associated clinical and socio-demographic factors, in a national sample of children 17 years and younger with ASD. The present study was a cross-sectional, observational study. Participants were caregivers of 1,193 children ages with ASD from the 2020 National Survey of Children's Health (NSCH). Hierarchical multiple linear regression analysis was run with age of ASD diagnosis as the criterion variable in two regression models. The binary composite medical home proxy variable was investigated as well as the five individual medical home components (usual source of care, personal doctor or nurse, family-centered care, care coordination, able to obtain referrals when needed). In the first regression analysis, the overall PCMH proxy variable was significantly correlated with the age of ASD diagnosis (standardized beta coefficient = -.08; p < .01). Of the five components of the PCMH assessed in the second regression model, only usual source of sick care was significantly associated with the age of ASD diagnosis (standardized beta coefficient = -.11; p < .01). Having a usual source of sick care may be an important factor in receiving an earlier ASD diagnosis for children and adolescents.

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来源期刊
CiteScore
4.00
自引率
4.50%
发文量
93
期刊介绍: Journal of Clinical Psychology in Medical Settings is an international forum for the publication of peer-reviewed original papers related to all areas of the science and practice of psychologists in medical settings. Manuscripts are chosen that have a broad appeal across psychology as well as other health care disciplines, reflecting varying backgrounds, interests, and specializations. The journal publishes original research, treatment outcome trials, meta-analyses, literature reviews, conceptual papers, brief scientific reports, and scholarly case studies. Papers accepted address clinical matters in medical settings; integrated care; health disparities; education and training of the future psychology workforce; interdisciplinary collaboration, training, and professionalism; licensing, credentialing, and privileging in hospital practice; research and practice ethics; professional development of psychologists in academic health centers; professional practice matters in medical settings; and cultural, economic, political, regulatory, and systems factors in health care. In summary, the journal provides a forum for papers predicted to have significant theoretical or practical importance for the application of psychology in medical settings.
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