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Access to Developmental Pediatrics Evaluations for At-Risk Children

Jimenez, Manuel E. MD, MS; Martinez Alcaraz, Emmanuel BS; Williams, Jerome PhD; Strom, Brian L. MD, MPH

Journal of Developmental & Behavioral Pediatrics: April 2017 - Volume 38 - Issue 3 - p 228–232
doi: 10.1097/DBP.0000000000000427
Brief Reports

Objective: To determine a national average wait time for developmental pediatric evaluations and to understand differences in access based on whether an appointment is requested by an English or Spanish-speaking caller.

Methods: We conducted a mystery shopper study in which a bilingual research assistant called developmental pediatrics programs affiliated with US children's hospitals listed on a public directory requesting an appointment for his simulated child experiencing a developmental problem. If an appointment was not provided, a wait time estimate was requested. Programs that provided an estimate in English were called within 24 hours using a translated script. We excluded programs that did not include a developmental pediatrician, only accepted referrals from within their health system or plan, focused on specific disorders, or did not conduct initial evaluations.

Results: Of 244 hospitals listed, 140 unique programs were identified and called in English. One hundred four programs were reached. Ninety programs met inclusion criteria, 75 provided an estimated wait time. The mean estimate was 5.4 months (standard deviation: 4.5). Among these 75 programs, 62 were reached in Spanish but only 55% provided a wait time estimate; 31% did not provide language accommodations. The difference between average estimates obtained in English and Spanish was not statistically significant.

Conclusion: Among a national sample of US children's hospitals, we identified barriers to evaluations conducted by developmental pediatricians including long wait times and inadequate Spanish language accommodations at some programs. More work is needed to identify optimal strategies to connect children with developmental concerns to evaluations when necessary.

This article has supplementary material on the web site: www.jdbp.org.

*Departments of Pediatrics and Family Medicine and Community Health, Robert Wood Johnson Medical School, Rutgers Biomedical Health Sciences, Newark, NJ;

Robert Wood Johnson Medical School, Rutgers Biomedical Health Sciences, New Brunswick, NJ;

Department of Marketing, Rutgers Business School, Rutgers, The State University of New Jersey, Newark, NJ;

§Office of the Chancellor, Rutgers Biomedical Health Sciences, Newark, NJ.

Address for reprints: Manuel E. Jimenez, MD, MS, Children's Health Institute of New Jersey, 89 French St, New Brunswick, NJ 08901; e-mail: jimenema@rwjms.rutgers.edu.

M. E. Jimenez is supported by the Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Program.

Disclosure: The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jdbp.org).

See the video abstract from the authors at JDBP.org.

Received October , 2016

Accepted January , 2017

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