Colocated Developmental-Behavioral Pediatrics in Primary Care: Improved Outcome Across Settings

Area of Science:

• Pediatrics
• Developmental-Behavioral Pediatrics
• Public Health

Background:

• Developmental concerns in young children require timely evaluation and intervention.
• Access to Developmental-Behavioral Pediatrics (DBP) services can be limited, particularly for low-income populations.
• Federally Qualified Health Centers (FQHCs) serve vulnerable patient groups who may face barriers to specialized care.

Purpose of the Study:

• To evaluate the effectiveness of a collocated "Rapid Developmental Evaluation" (RDE) model for DBP within a pediatric primary care FQHC.
• To assess the impact of colocation on patient access, wait times, and initiation of services for children with developmental concerns.
• To measure primary care clinician (PCC) satisfaction with the collocated model.

Main Methods:

• A retrospective chart review of 151 children over 27 months who received RDE at an FQHC.
• Data collected included referral dates, visit dates, diagnoses, and referrals to tertiary DBP centers.
• Primary care clinician satisfaction was surveyed.

Main Results:

• The RDE model reduced the average wait time for a developmental evaluation to 57 days, compared to 137.3 days for tertiary centers.
• Children referred from RDE to tertiary centers had a higher visit completion rate (77%) than those referred from other sites (54%).
• 73% of RDE-recommended therapeutic services were initiated by the time of the tertiary visit, with high diagnostic fidelity and PCC satisfaction.

Conclusions:

• Colocation of a DBP pediatrician in an FQHC setting effectively decreases wait times for developmental assessments.
• This model improves access to early intervention services for at-risk, low-income pediatric populations.
• The RDE model demonstrates high fidelity and satisfaction, improving care delivery for young children with developmental concerns.