Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114923

Susan C. Robinson, MPA, Lynn Seim, MSN, RN, and Roy Grant. The Children's Health Fund, 317 East 64th Street, New York, NY 10021, 212-535-9400, srobinson@chfund.org

Medically underserved children who face barriers to primary health care face even greater difficulties accessing pediatric subspecialty care. While the national average of pediatric patients referred by a primary provider for subspecialty care is 13%, the subspecialty referral rate for patients of projects in The Children's Health Fund's (CHF) National Network is as high as 23%. For medically underserved, at-risk patients, adherence to subspecialty appointments can be lower than 10%. CHF's Referral Management Initiative (RMI), implemented in Children's Health Projects located in New York, Washington DC, Dallas, South Florida and Los Angeles, offers a variety of interventions to increase adherence with subspecialty appointment at multiple points during a patient's referral process. Based in a medical home setting, projects provide patient education, mailed and telephone appointment reminders, advocacy with subspecialty providers to minimize long intervals between appointments, coordinated transportation, inclusion of subspecialty documentation in the primary care chart notes and translation services. RMI's comprehensive approach to patient care has helped to increase adherence to 51% in South Florida, 66% in Dallas, 66% in New York, 72% in Washington DC and 84% in Los Angeles. A comprehensive support system for patients and their families, including appointment reminders, transportation and limited wait times ensures adherence with subspecialty appointments. Prompt pediatric subspecialty treatment can prevent more illness, help to manage chronic illness and promote overall health, well-being and quality of life of the children served.

Learning Objectives:

• Demonstrate that the management of subspecialty referrals is critical to patients’ adherence with pediatric subspecialty appointments
• Discuss the innovative efforts of The Children’s Health Fund to ensure the accessibility of comprehensive pediatric medical care by a medically underserved, at-risk population

Keywords: Health Care Access,

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation