Impact of Integrated Care in a Pediatric Gastroenterology Clinic on Psychology Utilization

Abstract

Integrated care is increasingly recognized as an ideal treatment model for a variety of medical conditions, including pediatric gastroenterology. The current study aims to better understand the impact of psychology integration into a subspecialty gastroenterology clinic on referral patterns and psychology utilization. A retrospective chart review evaluated 504 unique referrals over a period of two years, including the 12-month period immediately pre and post integration of psychology services. The impact of integrated psychology and medical services included a large increase in the overall number of referrals placed, a significant increase in the rate of follow-through of these referrals, and a significant decrease in elapsed time from the referral to initial psychology appointment for referrals placed following the integration of psychology services. Utilization was not significantly affected by demographic characteristics (i.e., age, gender, distance from the hospital, insurance type). Referral characteristics, including referring physician and presenting problem, had varying impacts on patient follow-through depending on the time period studied, highlighting the complexity of integrated care’s impact on referral patterns and psychology utilization. Results add to existing literature on the benefits of integrated care and accentuate the need for better understanding and ultimately reducing the barriers to utilization of psychology services.