Insurance status and recognition of psychosocial problems : A report from the pediatric research in office settings and the ambulatory sentinel practice networks.
To examine the effect of insurance status on clinician recognition of psychosocial problems for pediatric primary care visits.
A cohort study of 10 250 visits by children 4 to 15 years old for nonemergent care.
Two large primary care research networks reported data from 172 primary care clinicians in office-based practice.
Ten thousand two hundred and fifty unique children presenting consecutively to participating physicians for nonemergent services with a parent or caregiver.
Main Outcome Measure
Children were classified as positive for psychosocial problems if their score on the parent-reported Pediatric Symptom Checklist exceeded the standard cutoff of 28.
Clinician recognition was obtained by report as a dichotomous variable.
Insurance status was categorized by payor and plan structure.
Clinicians did not recognize psychosocial problems for a substantial number of children with scores suggestive of marked psychosocial dysfunction on the Pediatric Symptom Checklist.
Insurance type was not associated with rates of recognition.
However, provider familiarity with patients, provider discipline, and patient demographics were associated with increased recognition of psychosocial problems. (...)
Mots-clés Pascal : Psychopathologie, Etude cohorte, Aspect social, Assurance maladie, Relation médecin malade, Traitement, Enfant, Homme, Etude comparative, Critère sélection, Evaluation, Système nerveux pathologie, Organisation santé
Mots-clés Pascal anglais : Psychopathology, Cohort study, Social aspect, Health insurance, Physician patient relation, Treatment, Child, Human, Comparative study, Selection criterion, Evaluation, Nervous system diseases, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0020898
Code Inist : 002B18C04. Création : 17/04/1998.