REVIEW ARTICLE
Paediatric integrated care in the primary care setting: A scoping review of populations served, models used and outcomes measured
Jill D. McLeigh,
Lauren Malthaner,
Caitlin Winebrenner,
Kimberly E. Stone,
Corresponding Author
Jill D. McLeigh
Children's Health, Rees-Jones Center for Foster Care Excellence, Dallas, Texas, USA
Department of Epidemiology, Human Genetics, and Environmental Sciences, UT Health School of Public Health, Dallas Campus, Dallas, Texas, USA
Correspondence
Jill D. McLeigh, Children's Health, Rees-Jones Center for Foster Care Excellence, 1935 Medical District Drive, Mailstop ST7.03, Dallas, TX 75235, USA.
Email: [email protected]
Search for more papers by this authorLauren Malthaner
Department of Epidemiology, Human Genetics, and Environmental Sciences, UT Health School of Public Health, Dallas Campus, Dallas, Texas, USA
Search for more papers by this authorCaitlin Winebrenner
University of Texas Southwestern Medical Center, Dallas, Texas, USA
Search for more papers by this authorKimberly E. Stone
Children's Health, Rees-Jones Center for Foster Care Excellence, Dallas, Texas, USA
University of Texas Southwestern Medical Center, Dallas, Texas, USA
Search for more papers by this authorJill D. McLeigh,
Lauren Malthaner,
Caitlin Winebrenner,
Kimberly E. Stone,
Corresponding Author
Jill D. McLeigh
Children's Health, Rees-Jones Center for Foster Care Excellence, Dallas, Texas, USA
Department of Epidemiology, Human Genetics, and Environmental Sciences, UT Health School of Public Health, Dallas Campus, Dallas, Texas, USA
Correspondence
Jill D. McLeigh, Children's Health, Rees-Jones Center for Foster Care Excellence, 1935 Medical District Drive, Mailstop ST7.03, Dallas, TX 75235, USA.
Email: [email protected]
Search for more papers by this authorLauren Malthaner
Department of Epidemiology, Human Genetics, and Environmental Sciences, UT Health School of Public Health, Dallas Campus, Dallas, Texas, USA
Search for more papers by this authorCaitlin Winebrenner
University of Texas Southwestern Medical Center, Dallas, Texas, USA
Search for more papers by this authorKimberly E. Stone
Children's Health, Rees-Jones Center for Foster Care Excellence, Dallas, Texas, USA
University of Texas Southwestern Medical Center, Dallas, Texas, USA
Search for more papers by this authorAbstract
Background
Paediatric integrated care (PIC), which involves primary care and behavioural health clinicians working together with patients and families, has been promoted as a best practice in the provision of care. In this context, behavioural health includes behavioural elements in the care of mental health and substance abuse conditions, chronic illness and physical symptoms associated with stress, and addressing health behaviours. Models of and contexts in which PIC has been applied vary, as do the outcomes and measures used to determine its value. Thus, this study seeks to better understand (1) what paediatric subpopulations are receiving integrated care, (2) which models of PIC are being studied, (3) what PIC outcomes are being explored and what measures and strategies are being used to assess those outcomes, and (4) whether the various models are resulting in positive outcomes. These questions have significant policy and clinical implications, given current national- and state-level efforts aimed at promoting integrated health care.
Methods
This study utilized Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews to identify relevant articles published between January 1994 and 30 June 2020. The search utilized three databases: PubMed, PsycInfo and CINAHL. A total of 28 articles met the eligibility criteria for inclusion.
Results
Overall, acceptability of PIC appears to be high for patients and providers, with access, screening and engagement generally increasing. However, several gaps in the knowledge base on PIC were uncovered, and for some studies, ascertaining which models of integrated care were being implemented proved difficult.
Conclusion
PIC has the potential to improve access to and quality of behavioural health care, but more research is needed to understand what models of PIC prove most beneficial and which policies and conditions promote cost efficiency. Rigorous evaluation of patient outcomes, provider training, institutional buy-in and system-level changes are needed.
CONFLICT OF INTERESTS
The authors have no conflicts of interest to disclose.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| cch13000-sup-0001-Scoping Review Tables revised.docxWord 2007 document , 54.3 KB |
Table S1: Levels of integration Table S2: Study characteristics Table S3: Integrated care model definitions and characteristics Table S4: Outcome categories by measure used Table S5: Summary of findings by level of integration |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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