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Wait Time and Documentation Required for Child Psychiatric Care Across Payer and Facility Types
Meghan M Mallya1,2, Carrie Chen2, Fatima Naqvi2
1Department of Psychiatry, University of North Carolina Hospitals, Chapel Hill.
Insights
Community health centers offer faster access to child psychiatric care than academic medical centers, but require more documentation. Reducing wait times and paperwork is crucial for improving pediatric mental health access.
Area of Science:
- Pediatric Psychiatry
- Health Services Research
- Healthcare Access
Background:
- Long wait times and extensive documentation hinder access to outpatient child psychiatric services.
- Academic medical centers (AMCs) and community health centers (CHCs) face challenges in providing timely pediatric mental healthcare.
Purpose of the Study:
- To compare quoted wait times and documentation requirements for child psychiatric appointments.
- To analyze differences across payer types (Blue Cross Blue Shield, Medicaid, self-pay) and facility types (AMCs vs. CHCs).
Main Methods:
- Cross-sectional study utilizing telephone surveys.
- Data collected from 70 AMCs and 68 CHCs between January and September 2024.
- Generalized estimating equations used to analyze associations between payer/facility type and wait times/documentation.
Main Results:
- CHCs had significantly shorter wait times (43.0 days) than AMCs (119.8 days).
- Medicaid patients experienced longer wait times at CHCs and AMCs compared to self-pay and BCBS patients, respectively.
- CHCs required more documents (2.2) than AMCs (1.4), with Medicaid patients at CHCs needing fewer documents than BCBS or self-pay patients.
Conclusions:
- Pediatric patients face shorter wait times at CHCs but encounter greater documentation burdens.
- Healthcare systems must address reducing wait times and documentation requirements to improve child psychiatric care access.
- Further policy and research are needed to streamline access to pediatric mental health services.
Objective:
Long wait times and stringent documentation requirements, such as identification and guardianship paperwork, can limit access to outpatient child psychiatric care at academic medical centers (AMCs) and community health centers (CHCs). This cross-sectional study aimed to compare quoted wait times and documentation requirements for obtaining child psychiatric appointments across payer types (Blue Cross Blue Shield [BCBS], Medicaid, and self-pay) at CHCs and AMCs.
Methods:
Between January and September 2024, data were collected via telephone survey from 70 nationally ranked AMCs and 68 CHCs. Generalized estimating equations were used to assess the associations of payer type and facility type with wait time and required documentation.
Results:
Wait times at CHCs were shorter than at AMCs (mean±SD=43.0±3.7 vs. 119.8±19.4 days, p<0.001). Medicaid patients waited longer than self-pay patients at CHCs (mean=48.7±29.3 vs. 32.0±25.7 days, p=0.021) and longer than BCBS patients at AMCs (mean=160.9±136.4 vs. 77.1±87.5 days, p=0.022). Documentation requirements were higher at CHCs compared with AMCs (mean=2.2±1.4 vs. 1.4±1.1 documents, p<0.001), although Medicaid patients (mean=1.9±1.2 documents) at CHCs were asked to provide fewer documents than BCBS or self-pay patients (mean=2.5±1.4, p=0.032, and mean=2.5±1.7, p=0.030, respectively).
Conclusions:
Pediatric patients had shorter wait times at CHCs than at AMCs, although more documents were required. Future policy work and research should focus on how health care systems can reduce child psychiatric wait times and documentation burdens.
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