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Identifying Risk Factors Associated with Repeated Referrals Within a Pediatric Navigation Program.

Caitlin Koob1,2, Mackenzie Stuenkel3, Ryan J Gagnon4

  • 1Department of Public Health Sciences, Clemson University, 501 Edwards Hall, Clemson, SC, USA. ckoob@clemson.edu.

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Patient navigation programs (PNPs) help children with developmental disorders. Older children with ADHD, behavioral issues, or Medicaid insurance are more likely to need repeated referrals, requiring program adjustments for at-risk groups.

Keywords:
Community healthHealth equityPatient navigation programPediatric mental and behavioral healthPolicy implications

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Area of Science:

  • Pediatric Healthcare
  • Health Services Research
  • Child Development

Background:

  • 1 in 5 US children aged 8 have mental, behavioral, or developmental disorders.
  • These children often face complex care needs and unmet healthcare demands.
  • Patient Navigation Programs (PNPs) aim to integrate care and manage referrals.

Purpose of the Study:

  • To identify factors associated with repeated referrals to a PNP.
  • To inform referral patterns and adapt navigation support for at-risk children.
  • To optimize the connection between referrals and services.

Main Methods:

  • Analysis of 15,702 referrals to a PNP from 2017-2022 in South Carolina.
  • Examined demographic, diagnostic, and insurance factors influencing repeated referrals.
  • Statistical analysis to identify predictors of repeated referrals.

Main Results:

  • 71.07% of children had no repeated referrals.
  • Higher risk for repeated referrals: older children, ADHD, behavioral concerns, depression, multiple needs, Medicaid insurance.
  • Lower risk for repeated referrals: non-Hispanic Black children, referrals from well-child visits, private/Tricare insurance.

Conclusions:

  • Medicaid-insured children, often younger and with multiple needs, face compounded risks.
  • Findings suggest adapting PNP protocols for at-risk populations.
  • Optimizing referral-to-service connections is crucial for equitable care delivery.