179: Integrating Developmental Services with School-Based Health Care: Feasibility, Efficacy and Relevance in a Universal Healthcare System
Notice bibliographique
Résumé
The School-based health center (SBHC) is an emerging model for developmental healthcare delivery in Canada. Despite access to universal healthcare, barriers such as language, cultural differences and transportation affect access for children in underserved populations in Canada. The Model Schools Pediatric Health Initiative is the first SBHC program in Ontario, Canada established to alleviate barriers inner city children face to accessing developmental care. As part of the program, pediatricians attend interdisciplinary monthly school based (school support team, SST) meetings to help identify which students require developmental assessments and then offer them through the participating SHBC. To provide an update on the Model Schools Pediatric Health Initiative SHBC program with respect to feasibility and efficacy. A retrospective chart review of all clinic users from November 2010 to January 2012 was conducted and a prospective longitudinal cross-sectional analysis was implemented from February 2012 to June 2013. Among those referred for developmental concerns, time from identification at the SST meeting to first developmental assessment at the SBHC was calculated. The feasibility metrics included the number of children who enrolled at the SBHC. The efficacy metrics included the proportion of enrolled children who attended the SBHC, the proportion of new diagnoses established, as well as wait times. In total, 1042 children enrolled at the SBHC and 443 (43%of those that enrolled) attended the SBHC. There were a total of 282 new diagnoses established at the SBHC and among these 181 (64%) were in the developmental diagnostic category. From March 2012 to April 2013, 41 students were referred for developmental assessments from the School Support Team (SST). Thirty-three assessments were completed at the time of analysis and the mean wait time from presentation at the SST to developmental assessment was 102 days. The SBHC has proven to be feasible and efficacious. This model relies on an integrated approach whereby pediatricians and school board professionals meet monthly to discuss and triage at risk students needing developmental assessments. This process allows for better understanding of school related problems and provides assessments within the school setting thereby eliminating some barriers to healthcare access. Relative to the standard of care this process is fast and efficient and creates an optimal setting to increase access to specialized developmental services for inner city children facing barriers to accessing health-care in Canada.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,023 | 0,041 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,001 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».