Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
Department of Pediatrics, UCLA Mattel Children's Hospital and Children's Discovery & Innovation Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.
Matern Child Health J. 2024 Nov;28(11):1911-1919. doi: 10.1007/s10995-024-03972-w. Epub 2024 Sep 11.
Lack of knowledge of Early Intervention (EI) is a barrier to developmental delay (DD) management. We aimed to examine the feasibility of measuring pediatricians' knowledge of EI, determine the distribution of EI knowledge, and determine factors associated with increased EI knowledge.
We conducted an exploratory cross-sectional study with a convenience sample from a local American Academy of Pediatrics chapter to administer a survey with 10 multiple-choice questions regarding the EI referral process, evaluation process, eligibility criteria and fee structure. Our outcome variable was a composite score of these 10 multiple-choice questions, Total Knowledge Score (TKS). Our predictor variables included physician characteristics (i.e., years of experience, percentage of patients seen with private insurance, receipt of EI training in the last 5 years) and practice characteristics (i.e., medical home status).
Our sample consisted of a total of 194 pediatric residents/attendings. Multivariable regression demonstrated seeing ≥ 50% patients who were privately insured, increased experience, and receiving training in the last 5 years were associated with higher TKS.
We were able to quantitatively evaluate physician's knowledge of EI and demonstrated that seeing a majority of privately insured patients, having more experience, and having received formal EI training in the last 5 years were associated with higher EI knowledge. This disproportionate distribution of EI knowledge has the potential to contribute to disparities in the management of DD. This may indicate that medical institutions, where physicians see a small percent of privately insured patients, need to hire more experienced physicians, and provide routine EI training.
缺乏对早期干预（EI）的了解是发育迟缓（DD）管理的障碍。我们旨在检查测量儿科医生对 EI 的知识的可行性，确定 EI 知识的分布，并确定与增加 EI 知识相关的因素。
我们进行了一项探索性的横断面研究，采用方便样本来自当地儿科学会分会，对 10 个多项选择题进行了调查，这些问题涉及 EI 转诊过程、评估过程、资格标准和费用结构。我们的结果变量是这 10 个多项选择题的综合分数，即总知识得分（TKS）。我们的预测变量包括医生特征（即经验年限、私人保险患者就诊比例、在过去 5 年内接受 EI 培训情况）和实践特征（即医疗之家状态）。
我们的样本共包括 194 名儿科住院医师/主治医生。多变量回归表明，看到≥50%的私人保险患者、增加经验和在过去 5 年内接受培训与更高的 TKS 相关。
我们能够定量评估医生对 EI 的知识，并表明看到大多数私人保险患者、经验更丰富以及在过去 5 年内接受过正规 EI 培训与更高的 EI 知识相关。这种 EI 知识的分配不均有可能导致 DD 管理方面的差异。这可能表明，医生只看到一小部分私人保险患者的医疗机构需要雇佣更有经验的医生，并提供常规的 EI 培训。
