The Children's Hospital at Westmead, Corner Hawkesbury Road and Hainsworth Street, Westmead, NSW, 2145, Australia.
University of Notre Dame Australia School of Medicine, Sydney, Australia.
BMC Health Serv Res. 2024 Mar 14;24(1):342. doi: 10.1186/s12913-024-10800-y.
Despite the increasing prevalence of neurodevelopmental disorders (NDD), data regarding access to child development services have remained limited globally. Long wait times are a major barrier to developmental assessments, impacting on care and outcomes. The aim is to retrospectively analyse the demographic profile and prioritisation of patients seen at a child developmental assessment service (CDAS) in a vulnerable region of Sydney, and explore factors affecting wait times.
Data was collated and analysed for 2354 patients from 2018 to 2022. Socio-Economic Indexes for Areas (SEIFA) were collated from the Australian Bureau of Statistics. Descriptive statistics were used for demographic data and various statistical methods were used to analyse the relationships and impact of factors likely to affect wait lists.
The median age was 51 months (IQR41-61) and males comprised 73.7% of the cohort. 64% of children were from culturally and linguistically diverse backgrounds (CALD) and 47% lived in the most disadvantaged suburbs. The median wait time was 302.5 days (IQR175-379) and 70% of children were seen within 12 months. CALD patients and children over 5-years had shorter wait times. Most children with Global Developmental Delay (GDD) were from the lowest four SEIFA deciles and waited longer for an appointment. 42.6% were seen within the priority allocated time or sooner. Children with ASD and/or severe GDD were prioritised to be seen earlier. Overall, the study could not demonstrate any difference in the wait times according to the prioritisation groups.
This study provides insights into the profile, prioritisation processes and wait lists of children seen by CDAS in South Western Sydney with high rates of social vulnerability and presents an argument to discuss benchmarking targets with service providers. It identifies the need to prioritise children living in suburbs with socioeconomic disadvantage and refine prioritisation and data collection processes to improve wait times.
尽管神经发育障碍（NDD）的患病率不断上升，但全球有关儿童发展服务获取的数据仍然有限。较长的等待时间是发育评估的主要障碍，影响着护理和结果。本研究旨在回顾性分析悉尼一个弱势地区儿童发育评估服务（CDAS）就诊患者的人口统计学特征和优先顺序，并探讨影响等待时间的因素。
从 2018 年至 2022 年，共收集了 2354 名患者的数据并进行了分析。社会经济指数（SEIFA）由澳大利亚统计局收集。使用描述性统计方法对人口统计学数据进行分析，并使用各种统计方法分析可能影响等待名单的因素的关系和影响。
中位年龄为 51 个月（IQR41-61），男性占队列的 73.7%。64%的儿童来自文化和语言多样化背景（CALD），47%居住在最贫困的郊区。中位等待时间为 302.5 天（IQR175-379），70%的儿童在 12 个月内就诊。CALD 患者和 5 岁以上儿童的等待时间较短。大多数患有全面发育迟缓（GDD）的儿童来自 SEIFA 得分最低的四个十分位数，等待预约的时间更长。42.6%的儿童在分配的优先时间或更短时间内就诊。患有 ASD 和/或严重 GDD 的儿童被优先安排更早就诊。总体而言，该研究未能证明根据优先顺序组别等待时间存在差异。
本研究深入了解了在高社会脆弱性的悉尼西南地区接受 CDAS 评估的儿童的特征、优先顺序流程和等待名单，并提出了与服务提供者讨论基准目标的论点。它确定了需要优先考虑居住在社会经济劣势郊区的儿童，并改进优先顺序和数据收集流程，以缩短等待时间。
