title: Comparison of specialist and nonspecialist care pathways for adolescents with anorexia nervosa and related eating disorders.
abstract: OBJECTIVE
  To explore the role of specialist outpatient eating disorders services and investigate how direct access to these affects rates of referral, admissions for inpatient treatment, and continuity of care.
  
  
  METHODS
  Services beyond primary care in Greater London retrospectively identified adolescents who presented with an eating disorder over a 2-year period. Data concerning service use were collected from clinical casenotes.
  
  
  RESULTS
  In areas where specialist outpatient services were available, 2-3 times more cases were identified than in areas without such services. Where initial outpatient treatment was in specialist rather than nonspecialist services, there was a significantly lower rate of admission for inpatient treatment and considerably higher consistency of care.
  
  
  CONCLUSIONS
  Developing specialist outpatient services with direct access from primary care is likely to lead to improvements in treatment and reduce overall costs.
authors.affiliation: Department of Psychology, Section of Family Therapy, Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Jennifer
authors.initials: J
authors.lastname: House
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schmidt
authors.forename: Meghan
authors.initials: M
authors.lastname: Craig
authors.forename: Sabine
authors.initials: S
authors.lastname: Landau
authors.forename: Mima
authors.initials: M
authors.lastname: Simic
authors.forename: Dasha
authors.initials: D
authors.lastname: Nicholls
authors.forename: Pippa
authors.initials: P
authors.lastname: Hugo
authors.forename: Mark
authors.initials: M
authors.lastname: Berelowitz
authors.forename: Ivan
authors.initials: I
authors.lastname: Eisler
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D000856:Anorexia Nervosa / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D003266:Continuity of Patient Care / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D017046:Cost Savings / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D008131:London; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D010343:Patient Admission / Q000191:economics / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D013038:Specialization; D013222:State Medicine / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D016896:Treatment Outcome