Department of Psychiatry (JM Murphy, A Riobueno-Naylor, JM Holcomb, A Dutta, MS Jellinek), Massachusetts General Hospital, Boston, Mass; Department of Psychiatry (JM Murphy, MS Jellinek), Harvard Medical School, Boston, Mass.
Department of Clinical and Quality Programs (S Stepanian, CP Giuliano, SC Bernstein), Affiliated Pediatric Practices, Dedham, Mass.
Acad Pediatr. 2021 May-Jun;21(4):702-709. doi: 10.1016/j.acap.2020.11.027. Epub 2020 Dec 4.
A network of 18 pediatric practice locations serving predominantly commercially insured patients implemented the electronic administration of the Pediatric Symptom Checklist-17 parent-report (PSC-17P) for all 5.50- to 17.99-year-old children seen for well child visits (WCVs) and wrote up the results as a quality improvement project. The current study investigated this screening over 2 years to assess its implementation and risk rates over time.
Parents completed the PSC-17P electronically before the visit and the scored data were immediately available in the patient's chart. Using billing and screening data, the study tracked rates of overall and positive screening during the first-year baseline (4 months) and full implementation phases of the project in the first (8 months) and second (12 months) year.
A total of 35,237 patients completed a WCV in the first year. There was a significant improvement in PSC-17P screening rates from the first-year baseline (26.3%) to full implementation (89.3%; P < .001) phases. In the second year, a total of 40,969 patients completed a WCV and 77.9% (n = 31,901) were screened, including 18,024 patients with screens in both years. PSC-17P screening rates varied significantly across the 18 locations and rates of PSC-17P risk differed significantly by practice, insurance type, sex, and age.
The current study demonstrated the feasibility of routine psychosocial screening over 2 years using the electronically administered PSC-17P in a network of pediatric practices. This study also corroborated past reports that PSC-17 risk rates differed significantly by insurance type (Medicaid vs commercial), sex, and age group.
一个由 18 个儿科诊所组成的网络，主要为商业保险患者服务，为所有 5.50 至 17.99 岁的定期儿童健康检查（WCV）就诊儿童实施了电子版儿童症状清单-17 家长报告（PSC-17P），并将结果作为一项质量改进项目记录下来。本研究在两年内对该筛查进行了调查，以评估其实施情况和随时间变化的风险率。
家长在就诊前通过电子方式完成 PSC-17P，评分数据会立即出现在患者的病历中。利用计费和筛查数据，研究人员在项目的第一年基线（4 个月）和全面实施阶段（第一年的 8 个月和第二年的 12 个月）跟踪了整体和阳性筛查的比率。
第一年共有 35237 名患者完成了 WCV。PSC-17P 筛查率从第一年基线（26.3%）显著提高到全面实施（89.3%；P<0.001）阶段。第二年，共有 40969 名患者完成了 WCV，其中 77.9%（n=31901）接受了筛查，包括 18024 名患者在两年内都接受了筛查。PSC-17P 筛查率在 18 个地点之间存在显著差异，并且在实践、保险类型、性别和年龄方面的 PSC-17P 风险率也存在显著差异。
本研究在儿科诊所网络中使用电子版 PSC-17P 进行了两年的常规心理社会筛查，证明了其可行性。本研究还证实了过去的报告，即 PSC-17 风险率因保险类型（医疗补助与商业）、性别和年龄组而异。
