Impact of Integrated Care in a Pediatric Gastroenterology Clinic on Psychology Utilization
Bibliographic record
Abstract
Integrated care is increasingly recognized as an ideal treatment model for a variety of medical conditions, including pediatric gastroenterology. The current study aims to better understand the impact of psychology integration into a subspecialty gastroenterology clinic on referral patterns and psychology utilization. A retrospective chart review evaluated 504 unique referrals over a period of two years, including the 12-month period immediately pre and post integration of psychology services. The impact of integrated psychology and medical services included a large increase in the overall number of referrals placed, a significant increase in the rate of follow-through of these referrals, and a significant decrease in elapsed time from the referral to initial psychology appointment for referrals placed following the integration of psychology services. Utilization was not significantly affected by demographic characteristics (i.e., age, gender, distance from the hospital, insurance type). Referral characteristics, including referring physician and presenting problem, had varying impacts on patient follow-through depending on the time period studied, highlighting the complexity of integrated care’s impact on referral patterns and psychology utilization. Results add to existing literature on the benefits of integrated care and accentuate the need for better understanding and ultimately reducing the barriers to utilization of psychology services.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".