Variations in ADHD treatment among special education students.
OBJECTIVE
To examine variation in patient characteristics (case-mix) and treatment patterns for attention-deficit/hyperactivity disorder (ADHD) by provider type.


METHODS
By means of a two-stage study design, 102 children were identified as receiving treatment for ADHD in the past year, among a school district-wide sample of second-through fourth-grade special education students. Parent and child interviews were conducted using standardized measures of need for treatment, service use, and process of care.


RESULTS
Nearly three fourths of the children received treatment for ADHD by a primary care provider, and of these, 68% did not have any contact with a mental health specialist. Children treated only by a primary care provider had fewer comorbid conditions, less impairment, and lower levels of family burden than children treated only by a mental health specialist. Treatment of ADHD solely by primary care providers was characterized by fewer sessions, less time with the patient, and less use of multimodal therapies.


CONCLUSIONS
Future studies examining clinical outcomes for ADHD treatment should take into account variation in case-mix and treatment patterns by provider type.
Bussing
R
R
Department of Psychiatry and Health Policy, University of Florida, Gainesville, USA.
Zima
B T
BT
Belin
T R
TR
D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000628:therapy*; D016009:Chi-Square Distribution; D002648:Child; D002662:Child Health Services / Q000592:standards / Q000706:statistics & numerical data; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D004519:Education, Special / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000592:standards / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care / Q000592:standards; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D014481:United States