Pediatrician coordination of care for children with mental illnesses.
BACKGROUND
Children with mental illnesses are seen across various service sectors, including pediatric primary care. As such, care coordination, which has been shown to improve outcomes, is especially important. Little is known about organizational and state level factors that might affect pediatricians' efforts to coordinate care for children with mental illnesses.


OBJECTIVE
This study used data from a survey of primary care pediatricians to examine organizational and state level variables associated with increased care coordination for children with mental illnesses.


METHODS
We undertook a cross-sectional study using data from a survey of pediatricians. A total of 1337 pediatricians in 6 states were surveyed about their care coordination and about organizational characteristics. State level data were gathered from various sources. A 5-item scale was developed for the dependent variable of past month coordination contacts (Cronbach's alpha = 0.82).


RESULTS
No state level variables were associated with pediatrician coordination behaviors. Having a regular case conferencing mechanism, staff assigned to coordinate care, and a mental health specialist in the practice were associated with increased past month coordination contacts. Pediatricians in rural practices coordinated care more frequently than those in other locations. Pediatricians who screened more and those with more experience had higher rates of care coordination.


CONCLUSIONS
Having a regular case conferencing mechanism, staff assigned to coordinate care, and a mental health specialist in the practice were associated with increased mental health care coordination. This information should be useful in planning ways to increase care coordination for children with mental illnesses seen in pediatric primary care.
Pfefferle
Susan G
SG
The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA. spfefferle@gwbmail.wustl.edu
Gittell
Jody Hoffer
JH
Hodgkin
Dominic
D
Ritter
Grant
G
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008484:Medicaid / Q000458:organization & administration; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D010346:Patient Care Management / Q000458:organization & administration*; D010372:Pediatrics; D011216:Practice Management, Medical / Q000458:organization & administration; D010818:Practice Patterns, Physicians' / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration; D012737:Sex Factors