Miller Anton R, Armstrong Robert W, Mâsse Louise C, Klassen Anne F, Shen Jane, O'Donnell Maureen E
Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Dev Med Child Neurol. 2008 Nov;50(11):815-21. doi: 10.1111/j.1469-8749.2008.03113.x. Epub 2008 Sep 20.
Concern about the length of time that children, young people, and families may have to wait to access assessment, diagnostic, interventional, therapeutic, and supportive child developmental and rehabilitation (CDR) services is widespread, but adequate data collection and research on this issue remain limited. We review key concepts and issues relevant to waiting for CDR services from the published literature, a national workshop devoted to this topic, and international experience. We conclude that gaps in data, evidence, and consensus challenge our ability to address the issue of waiting for CDR services in a systematic way. A program of research coupled with actions based on consensus-building is required. Research priorities include acquiring evidence of the appropriateness and effectiveness of different models of intervention and rehabilitation services, and documenting the experience and expectations of waiting families. Consensus-building processes are critical to identify, categorize, and prioritize 'sentinel' components of CDR service pathways: (1) to reduce the inherent complexity of the field; (2) to create benchmarks for waiting for these respective services; and (3) to develop definitions for wait-time subcomponents in CDR services. Collection of accurate and replicable data on wait times for CDR services can be used to document baseline realities, to monitor and improve system performance, and to conduct comparative and analytic research in the field of CDR services.
人们普遍担心儿童、青少年及其家庭在获得评估、诊断、介入、治疗以及支持性儿童发育与康复（CDR）服务时可能需要等待的时间，但关于这一问题的充分数据收集和研究仍然有限。我们从已发表的文献、一个专门讨论该主题的全国性研讨会以及国际经验中，回顾了与等待CDR服务相关的关键概念和问题。我们得出结论，数据、证据和共识方面的差距挑战了我们以系统方式解决等待CDR服务问题的能力。需要开展一项研究计划，并基于建立共识采取行动。研究重点包括获取不同干预和康复服务模式的适宜性和有效性的证据，以及记录等待服务家庭的经历和期望。建立共识的过程对于识别、分类和确定CDR服务路径的“关键”组成部分的优先级至关重要：（1）降低该领域固有的复杂性；（2）为等待这些相应服务设定基准；（3）为CDR服务中的等待时间子组件制定定义。收集关于CDR服务等待时间的准确且可重复的数据，可用于记录基线现实情况、监测和改善系统性能，以及在CDR服务领域进行比较和分析研究。
