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The Quality of Care for Australian Children with Autism Spectrum Disorders

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Abstract

Knowledge about the quality of care delivered to children with autism spectrum disorders (ASD) in relation to that recommended by clinical practice guidelines (CPGs) is limited. ASD care quality indicators were developed from CPGs and validated by experts, then used to assess the quality of care delivered by general practitioners (GPs) and pediatricians in Australia. Data were retrospectively collected from the medical records of 228 children (≤ 15 years) with ASD for 2012–2013. Overall quality of care was high, but with considerable variation among indicators, and between GPs and pediatricians—e.g., GPs were less likely to complete the assessment care bundle (61%; 95% CI 21–92). Findings highlight potential areas for improvement in the need for standardized criteria for diagnosis.

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Notes

  1. This figure comprised 5 indicator assessments for a patient who visited outside the study period, and 38 indicators for patients who were too old for inclusion in the study.

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Acknowledgments

We acknowledge with gratitude the fieldwork conducted by our surveying team: Florence Bascombe, Jane Bollen, Samantha King, Naomi Lamberts, Amy Lowe, AnnMarie McEvoy, Stephanie Richardson, Jane Summers, and Annette Sutton; thanks also go to Stan Goldstein, Annie Lau and Nicole Mealing for their earlier contributions. Thanks also go to those who provided data for planning and analysis of CTK: (1) Queensland Health, the NSW Ministry of Health and South Australia Health; (2) the Australian Paediatric Research Network; (3) the Bettering the Evaluation and Care of Health Program, University of Sydney; and (4) the Australian Department of Human Services.

Funding

This work was supported by an Australian National Health and Medical Research Council Partnership Grant (APP1065898), with contributions by the National Health and Medical Research Council, Bupa Health Foundation, Sydney Children’s Hospital Network, New South Wales Kids and Families, Children’s Health Queensland, and the South Australian Department of Health (SA Health).

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Authors and Affiliations

  1. Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, North Ryde, NSW, 2109, Australia

    K. Churruca, L. A. Ellis, J. C. Long, C. Pomare, L. K. Wiles, G. Arnolda, H. P. Ting, P. Hibbert & J. Braithwaite

  2. Australian Centre for Precision Health, School of Health Sciences, University of South Australia Cancer Research Institute, University of South Australia, Level 8, North Terrace, GPO Box 2471, Adelaide, SA, 5001, Australia

    L. K. Wiles & P. Hibbert

  3. Department of Community Child Health, Sydney Children’s Hospitals Network, School of Women and Children’s Health, University of New South Wales, Sydney Children’s Hospital, Level 3, High Street, Randwick, NSW, 2031, Australia

    S. Woolfenden

  4. Tumbatin Developmental Clinic, Sydney Children’s Hospital Network, School of Women and Children’s Health, University of New South Wales, Sydney Children’s Hospital, High Street, Randwick, NSW, 2031, Australia

    V. Sarkozy

  5. Healthcare Improvement Unit, Clinical Excellence Division, Queensland Health, Brisbane, Australia

    C. de Wet

  6. School of Medicine, Griffith University, Gold Coast, Gold Coast Campus, Brisbane, QLD, 4222, Australia

    C. de Wet

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  1. K. Churruca
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  2. L. A. Ellis
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  3. J. C. Long
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  4. C. Pomare
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  6. G. Arnolda
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  7. H. P. Ting
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  8. S. Woolfenden
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  9. V. Sarkozy
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  10. C. de Wet
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  11. P. Hibbert
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  12. J. Braithwaite
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Consortia

the CareTrack Kids Investigative Team

Contributions

JB and PH designed the overall study. LKW, SW and VS contributed to the design of Autism Spectrum Disorders study. JB, PH, GA, and HPT carried out the collection and statistical analysis of the data. KC drafted the manuscript and was responsible for coordination of all aspects of the work. LAE, CP, JCL, LKW and CdW reviewed and made substantial contributions to earlier drafts. All authors contributed to the interpretation of results and the final manuscript.

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Correspondence to K. Churruca.

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Churruca, K., Ellis, L.A., Long, J.C. et al. The Quality of Care for Australian Children with Autism Spectrum Disorders. J Autism Dev Disord 49, 4919–4928 (2019). https://doi.org/10.1007/s10803-019-04195-7

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