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跨学科团队评估:自闭症谱系障碍诊断评估的有效方法。

Interdisciplinary Team Evaluation: An Effective Method for the Diagnostic Assessment of Autism Spectrum Disorder.

机构信息

Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA.

Seattle Children's Autism Center, Seattle Children's Hospital, Seattle, WA.

出版信息

J Dev Behav Pediatr. 2018 May;39(4):271-281. doi: 10.1097/DBP.0000000000000549.

Abstract

OBJECTIVE

The objective of this research is to assess the feasibility of an interdisciplinary team diagnostic assessment model for autism spectrum disorder (ASD).

METHOD

Medical records from 366 patients evaluated for ASD at the Seattle Children's Autism Center (SCAC) were reviewed. ASD diagnostic outcomes, provider satisfaction, engagement in follow-up care, billed time, and reimbursement amounts were compared in patients evaluated through an interdisciplinary team approach (n = 91) with those seen in multidisciplinary evaluations led by either a psychologist (n = 165) or a physician (n = 110).

RESULTS

Diagnostic determination was made in 90% of patients evaluated through the interdisciplinary team model in a single day. Rates of ASD diagnosis were similar across the 3 tracks, ranging from 61% to 72%. Demographic characteristics did not impact the likelihood of ASD diagnosis. Rates of patient follow-up care and provider satisfaction were significantly higher in interdisciplinary versus multidisciplinary teams. Interdisciplinary team evaluations billed 1.8 fewer hours yet generated more net hourly clinic income compared with psychology-led multidisciplinary evaluations.

CONCLUSION

An interdisciplinary team approach, focusing on ruling-in or ruling-out ASD, was sufficient to determine ASD diagnosis in most patients seen at the SCAC Interdisciplinary teams generated more clinic income and decreased the time spent in evaluation compared with a psychology-led approach. They did so while maintaining consistency in diagnostic rates, demonstrating increased provider satisfaction and an increased likelihood of engagement in follow-up care.

摘要

目的

本研究旨在评估自闭症谱系障碍(ASD)跨学科团队诊断评估模型的可行性。

方法

回顾了在西雅图儿童自闭症中心(SCAC)评估 ASD 的 366 名患者的医疗记录。通过跨学科团队方法(n = 91)评估的患者与通过心理学家(n = 165)或医生(n = 110)领导的多学科评估的患者相比,比较了 ASD 诊断结果、提供者满意度、参与随访护理、计费时间和报销金额。

结果

在跨学科团队模型中,有 90%的患者在一天内完成了诊断。3 条轨道上的 ASD 诊断率相似,范围从 61%到 72%。人口统计学特征不影响 ASD 诊断的可能性。与多学科团队相比,接受跨学科团队评估的患者的后续护理和提供者满意度的比例明显更高。与以心理学为主导的多学科评估相比,跨学科团队评估计费减少了 1.8 小时,但每小时的净诊所收入却增加了。

结论

以确定或排除 ASD 为重点的跨学科团队方法足以确定 SCAC 大多数患者的 ASD 诊断。跨学科团队产生了更多的诊所收入,减少了评估时间,同时保持了诊断率的一致性,表现出更高的提供者满意度和更高的后续护理参与度。

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