Abstract
BackgroundTo investigate timely access to and the time needed to complete the diagnostic path of children and adolescents with suspected attention deficit hyperactivity disorder (ADHD) in the 18 Italian Lombardy Region ADHD reference centers.MethodsData of children and adolescents enrolled in the Regional ADHD disease-oriented Registry for suspected ADHD who requested their first visit in 2013–2017 were analyzed.ResultsThe sample comprised 2262 children and adolescents aged 5–17 years who accessed the ADHD centers for diagnostic classification and management. The median waiting time was of 177 days (range 66–375) from the request for the initial appointment to the completion of the diagnostic path, with a three - fold difference between centers. In addition to the center, the strongest significant predictors of long waiting times were age comorbidities, the severity of the disorder, and having already completed some diagnostic procedures provided by the common standard path.ConclusionsTo guarantee an equal standard of care in ADHD centers for all children and adolescents there is a pressing need to reduce the times to complete the diagnostic path. It is the task of both policymakers and each center to optimize the quality of the service and of the care delivered.
Highlights
To investigate timely access to and the time needed to complete the diagnostic path of children and adolescents with suspected attention deficit hyperactivity disorder (ADHD) in the 18 Italian Lombardy Region ADHD reference centers
Large differences in access and waiting times in Child and Adolescent Neuropsychiatric Services (CANPS) have been reported in a few settings [13, 14] so they are to be expected in Bonati et al BMC Health Services Research (2019) 19:673 centers for attention-deficit hyperactivity disorder (ADHD) too
We used the methodology previously described and reporting details concerning: the local health setting [19], the characteristics of the ADHD Registry activated in Lombardy in June 2011 [20,21,22], the systematic work made by the18 ADHD centers belonging to the Lombardy ADHD Group [23], the rigorous diagnostic assessment approved by all involved clinicians [24, 25], the evaluation of follow-up and the effect size of provided care [26]
Summary
To investigate timely access to and the time needed to complete the diagnostic path of children and adolescents with suspected attention deficit hyperactivity disorder (ADHD) in the 18 Italian Lombardy Region ADHD reference centers. Patients suffering from mental health conditions who do not receive timely care, often experience a rapid decline in their conditions - with a lost opportunity for effective treatment [7, 8]. Large differences in access and waiting times in CANPS have been reported in a few settings [13, 14] so they are to be expected in Bonati et al BMC Health Services Research (2019) 19:673 centers for attention-deficit hyperactivity disorder (ADHD) too
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