RESUMO
Primary care physicians have an important role in assuring that children with autism are identified as early as possible and have a medical home providing appropriate care and care coordination. Understanding efficient methods of care and modifying practice habits to minimize services not currently supported by procedural codes will permit the primary clinician to be paid for this medical care. Current medical procedure codes can be legitimately used to bill for care related to developmental and behavioral health needs and consistent use of these codes will help address payment barriers.
Assuntos
Transtorno Autístico , Formulário de Reclamação de Seguro , Adolescente , Transtorno Autístico/diagnóstico , Transtorno Autístico/terapia , Criança , Serviços de Saúde da Criança/economia , Serviços de Saúde da Criança/organização & administração , Current Procedural Terminology , Humanos , Papel do Médico , Atenção Primária à Saúde , Mecanismo de Reembolso/organização & administraçãoRESUMO
Because services for children with autism spectrum disorder (ASD) are scarce, when children fail a broadband screening measure, providers need to carefully discern which children need ASD evaluations and which do not. This research considers how well a broadband screening test sorts those with and without probable ASD. The subjects were 427 children between 18 and 59 months of age with elevated risk scores on broadband screening, ie, Parents' Evaluation of Developmental Status (PEDS), a 10-item measure eliciting parents' concerns. Parents also completed the Modified Checklist of Autism in Toddlers (M-CHAT), an autism specific screen. The results showed that of the 427 children at risk on PEDS, 34% (N = 144) passed the M-CHAT. To determine whether these potential overreferrals could be reduced, parents' concerns on PEDS were used to predict M-CHAT results. Three or more discrete types of concerns, varying by age, characterized children who failed the M-CHAT while fewer than 3 were associated with passing. This reduced overreferrals by 70% while maintaining high levels of sensitivity (81%). Although compliance with the American Academy of Pediatrics recommendations for both broadband and autism-specific screening at 18 and 24 months is still recommended, viewing performance patterns on a broadband screening test can substantially reduce overreferrals to autism specialty services.
