RT Journal Article
SR Electronic
T1 Provider Specialty and Receipt of Metabolic Monitoring for Children Taking Antipsychotics
JF Pediatrics
JO Pediatrics
FD American Academy of Pediatrics
SP e20200658
DO 10.1542/peds.2020-0658
VO 147
IS 1
A1 Shenkman, Elizabeth
A1 Thompson, Lindsay
A1 Bussing, Regina
A1 Forrest, Christopher B.
A1 Woodard, Jennifer
A1 Sun, Yijun
A1 Mack, Jasmine
A1 Mistry, Kamila B.
A1 Gurka, Matthew J.
YR 2021
UL http://pediatrics.aappublications.org/content/147/1/e20200658.abstract
AB BACKGROUND AND OBJECTIVES: Metabolic monitoring is important for children taking antipsychotic medication, given the risk for increased BMI, impaired glucose metabolism, and hyperlipidemia. The purpose was to examine the influence of provider specialty on the receipt of metabolic monitoring. Specifically, differences in the receipt of recommended care when a child receives outpatient care from a primary care provider (PCP), a mental health provider with prescribing privileges, or both was examined.METHODS: Medicaid enrollment and health care and pharmacy claims data from 2 states were used in the analyses. Providers were assigned to specialties by using a crosswalk of the National Provider Identifier numbers to specialty type. A total of 41 078 children were included.RESULTS: For both states, 61% of children saw ≥1 provider type and had adjusted odds ratios for receiving metabolic monitoring that were significantly higher than those of children seeing PCPs only. For example, children seeing a PCP and a mental health provider with prescribing privileges during the year had adjusted odds of receiving metabolic monitoring that were 42% higher than those seeing a PCP alone (P < .001).CONCLUSIONS: Shared care arrangements significantly increased the chances that metabolic monitoring would be done. For states, health plans, and clinicians to develop meaningful quality improvement strategies, identifying the multiple providers caring for the children and potentially responsible for ordering tests consistent with evidence-based care is essential. Provider attribution in the context of shared care arrangements plays a critical role in driving quality improvement efforts.