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Do Subspecialists Ask About and Refer Families with Psychosocial Concerns? A Comparison with General Pediatricians

Cori Green1,2, Ruth E K Stein3, Amy Storfer-Isser4

  • 1General Academic Pediatrics, Weill Cornell Medical College/NewYork Presbyterian Hospital, New York, NY, USA. cmg9004@med.cornell.edu.

Maternal and Child Health Journal
|July 22, 2018
PubMed

Insights

Pediatricians rarely screen for or refer psychosocial concerns, with subspecialists doing so even less. General pediatricians are more likely to address these issues than subspecialists.

Area of Science:

  • Pediatric Healthcare
  • Child Psychology
  • Public Health

Background:

  • Psychosocial concerns significantly impact child health and are frequently observed in children with chronic illnesses.
  • Pediatric subspecialists often encounter complex psychosocial issues in their patients, complicating care delivery.
  • Addressing children's psychosocial needs requires consistent screening and referral practices among all pediatricians.

Purpose of the Study:

  • To compare the practices of general pediatricians versus subspecialists in inquiring/screening for psychosocial concerns.
  • To assess referral patterns for psychosocial concerns among different pediatric practice types.
  • To identify physician and practice characteristics associated with screening and referral behaviors.

Main Methods:

  • A cross-sectional study utilizing the 2013 American Academy of Pediatrics Periodic Survey of Fellows.
  • Analysis included 304 general pediatricians and 147 subspecialists, comparing practices for 10 psychosocial concerns.
  • Weighted univariate, bivariate, and multivariable analyses were performed, adjusting for covariates.

Main Results:

  • Less than half of all surveyed pediatricians routinely screened for most psychosocial concerns.
  • Subspecialists were less likely than general pediatricians to inquire/screen (IRR 1.41) and refer (IRR 1.59) for psychosocial concerns.
  • Recent attendance at child/adolescent mental health lectures was associated with increased screening (IRR 1.24).

Conclusions:

  • Pediatricians infrequently screen for and refer psychosocial concerns, indicating a gap in routine care.
  • Subspecialists demonstrate even lower rates of addressing these critical psychosocial issues compared to generalists.
  • Enhanced training and awareness regarding child mental health may improve screening and referral practices.

Keywords:
Developmental and behavioral pediatricsGeneral pediatriciansMental healthPsychosocial factorsSubspecialists

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