Bussing R, Zima B T, Belin T R
Department of Psychiatry and Health Policy, University of Florida, Gainesville, USA.
J Am Acad Child Adolesc Psychiatry. 1998 Sep;37(9):968-76. doi: 10.1097/00004583-199809000-00017.
To examine variation in patient characteristics (case-mix) and treatment patterns for attention-deficit/hyperactivity disorder (ADHD) by provider type.
By means of a two-stage study design, 102 children were identified as receiving treatment for ADHD in the past year, among a school district-wide sample of second-through fourth-grade special education students. Parent and child interviews were conducted using standardized measures of need for treatment, service use, and process of care.
Nearly three fourths of the children received treatment for ADHD by a primary care provider, and of these, 68% did not have any contact with a mental health specialist. Children treated only by a primary care provider had fewer comorbid conditions, less impairment, and lower levels of family burden than children treated only by a mental health specialist. Treatment of ADHD solely by primary care providers was characterized by fewer sessions, less time with the patient, and less use of multimodal therapies.
Future studies examining clinical outcomes for ADHD treatment should take into account variation in case-mix and treatment patterns by provider type.
