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Skipping the Line: Inequality in Access to Developmental-Behavioral Care.

Publication ,  Journal Article
McCafferty, S; Pereira-Smith, S; Koshy, AJ; Valdez, P; Nyp, SS
Published in: J Dev Behav Pediatr
December 1, 2022

The mother of an 18-month-old boy contacted the developmental and behavioral pediatrics clinic to request an evaluation because of concerns that her son is not using any words and only recently began walking. The child's mother became upset when she was notified that the clinic policy requires receipt of a formal request for evaluation from the primary care physician and that the first available appointment was in 9 months. Later that day, the child's grandmother contacted the clinic and reported that she is a member of the Donor Society affiliated with the university/medical system. Membership in the Donor Society is granted to individuals who have met specific philanthropic thresholds benefiting the university. One benefit to members of the Donor Society is the ability to access subspecialty medical services for themselves and their family members, across all disciplines, within 5 business days of their request.After confirming the details of the Donor Society promise with the philanthropic department of the hospital, a small committee of professionals within the clinic gathered to discuss the implications of this promised benefit to Donor Society members. This clinic is the only source for specialized, multidisciplinary developmental-behavioral health care that accepts public insurance within a 200-mile radius. The current waitlist for evaluation is 9 to 15 months depending on the reason for referral, and approximately 75% of patients on the waitlist receive some form of public assistance and/or live in a rural or underserved area. During the discussion, it was noted that there are 2 developmental-behavioral pediatric clinicians who practice within a cash-based private practice setting in the community. The waitlist for that practice was recently reported to be 3 to 6 months depending on the reason for evaluation, but that practice also requires a referral from the primary care physician before scheduling an initial evaluation.How would you recommend that the clinicians in the developmental and behavioral pediatrics clinic respond to the request to fulfill the promises made by the university to members of the Donor Society? How does a promise such as this one made to the Donor Society affect structural inequalities within the health care system and what strategies could be used to mitigate further inequalities that may result?

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Published In

J Dev Behav Pediatr

DOI

EISSN

1536-7312

Publication Date

December 1, 2022

Volume

43

Issue

9

Start / End Page

545 / 547

Location

United States

Related Subject Headings

  • Rural Population
  • Referral and Consultation
  • Male
  • Infant
  • Humans
  • Female
  • Family
  • Developmental & Child Psychology
  • Delivery of Health Care
  • Child
 

Citation

APA
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ICMJE
MLA
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McCafferty, S., Pereira-Smith, S., Koshy, A. J., Valdez, P., & Nyp, S. S. (2022). Skipping the Line: Inequality in Access to Developmental-Behavioral Care. J Dev Behav Pediatr, 43(9), 545–547. https://doi.org/10.1097/DBP.0000000000001127
McCafferty, Shawna, Silvia Pereira-Smith, Anson J. Koshy, Purnima Valdez, and Sarah S. Nyp. “Skipping the Line: Inequality in Access to Developmental-Behavioral Care.J Dev Behav Pediatr 43, no. 9 (December 1, 2022): 545–47. https://doi.org/10.1097/DBP.0000000000001127.
McCafferty S, Pereira-Smith S, Koshy AJ, Valdez P, Nyp SS. Skipping the Line: Inequality in Access to Developmental-Behavioral Care. J Dev Behav Pediatr. 2022 Dec 1;43(9):545–7.
McCafferty, Shawna, et al. “Skipping the Line: Inequality in Access to Developmental-Behavioral Care.J Dev Behav Pediatr, vol. 43, no. 9, Dec. 2022, pp. 545–47. Pubmed, doi:10.1097/DBP.0000000000001127.
McCafferty S, Pereira-Smith S, Koshy AJ, Valdez P, Nyp SS. Skipping the Line: Inequality in Access to Developmental-Behavioral Care. J Dev Behav Pediatr. 2022 Dec 1;43(9):545–547.

Published In

J Dev Behav Pediatr

DOI

EISSN

1536-7312

Publication Date

December 1, 2022

Volume

43

Issue

9

Start / End Page

545 / 547

Location

United States

Related Subject Headings

  • Rural Population
  • Referral and Consultation
  • Male
  • Infant
  • Humans
  • Female
  • Family
  • Developmental & Child Psychology
  • Delivery of Health Care
  • Child