Interdisciplinary Approaches Suggested for Children With Multiple Hospital Referrals Presenting With Non-specific Conditions
Aims: To describe the care patterns of patients with repeated referrals to both mental and somatic specialist healthcare, and to study their diagnostic processes.Methods: In a previous register study patients aged 6–12 years referred to Haukeland University Hospital from 2013 to 2015, we found 922 c...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-04-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2021.656939/full |
| _version_ | 1819291328321683456 |
|---|---|
| author | Irene Elgen Irene Elgen Ragnhild Lygre Gottfried Greve Gottfried Greve Silja Griffiths Torhild Heggestad |
| author_facet | Irene Elgen Irene Elgen Ragnhild Lygre Gottfried Greve Gottfried Greve Silja Griffiths Torhild Heggestad |
| author_sort | Irene Elgen |
| collection | DOAJ |
| description | Aims: To describe the care patterns of patients with repeated referrals to both mental and somatic specialist healthcare, and to study their diagnostic processes.Methods: In a previous register study patients aged 6–12 years referred to Haukeland University Hospital from 2013 to 2015, we found 922 children with at least three referrals including both somatic and mental health services. Of these, more than one in four (250) were randomly selected and observed from their first hospital episode ever and further after inclusion followed during their next three referrals or until July 2017. Data on referral patterns and diagnostics were collected from patient hospital records.Results: Mean number of referrals was 6.5 prior to inclusion and 4.2 in the follow-up period. At the end of the study period 15% of patients still had a non-specific diagnosis. During the follow-up period, more than half of the children were again referred across the border between somatic and mental healthcare.Conclusion: Very complex care patterns were found for these patients, who were repeatedly being referred and “crossing over” between mental and somatic healthcare. This indicates a need for more interdisciplinary-based approaches both within specialist care and between different care levels to broaden the perspective and achieve shorter time lag before reaching a diagnostic conclusion.Trial Registration: Data was obtained from Haukeland university hospital the patient registry system No. 2017/12470. Start of registration was April 1th 2017 and patients included was from 2013 to 15. |
| first_indexed | 2024-12-24T03:36:53Z |
| format | Article |
| id | doaj.art-d073491203c845e9b5ef8e79f724dd31 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-24T03:36:53Z |
| publishDate | 2021-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-d073491203c845e9b5ef8e79f724dd312022-12-21T17:17:02ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-04-01910.3389/fped.2021.656939656939Interdisciplinary Approaches Suggested for Children With Multiple Hospital Referrals Presenting With Non-specific ConditionsIrene Elgen0Irene Elgen1Ragnhild Lygre2Gottfried Greve3Gottfried Greve4Silja Griffiths5Torhild Heggestad6Division of Psychiatry, Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, NorwayDepartment of Clinical Medicine, University of Bergen, Bergen, NorwayDivision of Psychiatry, Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, NorwayDepartment of Clinical Science, University of Bergen, Bergen, NorwayDepartment of Heart Disease, Haukeland University Hospital, Bergen, NorwayDepartment of Child and Adolescent Medicine, Haukeland University Hospital, Bergen, NorwayDepartment of Research & Development, Haukeland University Hospital, Bergen, NorwayAims: To describe the care patterns of patients with repeated referrals to both mental and somatic specialist healthcare, and to study their diagnostic processes.Methods: In a previous register study patients aged 6–12 years referred to Haukeland University Hospital from 2013 to 2015, we found 922 children with at least three referrals including both somatic and mental health services. Of these, more than one in four (250) were randomly selected and observed from their first hospital episode ever and further after inclusion followed during their next three referrals or until July 2017. Data on referral patterns and diagnostics were collected from patient hospital records.Results: Mean number of referrals was 6.5 prior to inclusion and 4.2 in the follow-up period. At the end of the study period 15% of patients still had a non-specific diagnosis. During the follow-up period, more than half of the children were again referred across the border between somatic and mental healthcare.Conclusion: Very complex care patterns were found for these patients, who were repeatedly being referred and “crossing over” between mental and somatic healthcare. This indicates a need for more interdisciplinary-based approaches both within specialist care and between different care levels to broaden the perspective and achieve shorter time lag before reaching a diagnostic conclusion.Trial Registration: Data was obtained from Haukeland university hospital the patient registry system No. 2017/12470. Start of registration was April 1th 2017 and patients included was from 2013 to 15.https://www.frontiersin.org/articles/10.3389/fped.2021.656939/fulldiagnostic overshadowingpatient flowmental healthmulti-referralspsychosomaticschild |
| spellingShingle | Irene Elgen Irene Elgen Ragnhild Lygre Gottfried Greve Gottfried Greve Silja Griffiths Torhild Heggestad Interdisciplinary Approaches Suggested for Children With Multiple Hospital Referrals Presenting With Non-specific Conditions Frontiers in Pediatrics diagnostic overshadowing patient flow mental health multi-referrals psychosomatics child |
| title | Interdisciplinary Approaches Suggested for Children With Multiple Hospital Referrals Presenting With Non-specific Conditions |
| title_full | Interdisciplinary Approaches Suggested for Children With Multiple Hospital Referrals Presenting With Non-specific Conditions |
| title_fullStr | Interdisciplinary Approaches Suggested for Children With Multiple Hospital Referrals Presenting With Non-specific Conditions |
| title_full_unstemmed | Interdisciplinary Approaches Suggested for Children With Multiple Hospital Referrals Presenting With Non-specific Conditions |
| title_short | Interdisciplinary Approaches Suggested for Children With Multiple Hospital Referrals Presenting With Non-specific Conditions |
| title_sort | interdisciplinary approaches suggested for children with multiple hospital referrals presenting with non specific conditions |
| topic | diagnostic overshadowing patient flow mental health multi-referrals psychosomatics child |
| url | https://www.frontiersin.org/articles/10.3389/fped.2021.656939/full |
| work_keys_str_mv | AT ireneelgen interdisciplinaryapproachessuggestedforchildrenwithmultiplehospitalreferralspresentingwithnonspecificconditions AT ireneelgen interdisciplinaryapproachessuggestedforchildrenwithmultiplehospitalreferralspresentingwithnonspecificconditions AT ragnhildlygre interdisciplinaryapproachessuggestedforchildrenwithmultiplehospitalreferralspresentingwithnonspecificconditions AT gottfriedgreve interdisciplinaryapproachessuggestedforchildrenwithmultiplehospitalreferralspresentingwithnonspecificconditions AT gottfriedgreve interdisciplinaryapproachessuggestedforchildrenwithmultiplehospitalreferralspresentingwithnonspecificconditions AT siljagriffiths interdisciplinaryapproachessuggestedforchildrenwithmultiplehospitalreferralspresentingwithnonspecificconditions AT torhildheggestad interdisciplinaryapproachessuggestedforchildrenwithmultiplehospitalreferralspresentingwithnonspecificconditions |