Characterizing psychosocial services in a pediatric urology practice

• Published in: Journal of pediatric urology 2024-04, Vol.20 (2), p.242.e1-242.e8
• Main Authors: Xu, Rena, Hayes, Lillian C., Cai, Peter Y., Meers, Amanda, Tulley, Kelsey, Antonelli, Richard C., Estrada, Carlos R.
• Format: Article
• Language: English
• Subjects: Care coordination; Child; Child, Preschool; Female; Humans; Male; Outpatients; Pediatric urology; Psychosocial intervention; Psychosocial support; Referral and Consultation; Social determinants of health; Surveys and Questionnaires; Urology
• ISSN: 1477-5131; 1873-4898; 1873-4898
• DOI: 10.1016/j.jpurol.2023.11.011

Psychosocial needs, which encompass behavioral health and social determinants of health (SDOH), are important mediators of the patient experience and health outcomes. However, many practices have limited experience with systematically assessing the non-billable psychosocial services provided to patients and families. To characterize the non-billable activities of three psychosocial providers in a pediatric urology practice at a freestanding children's hospital. Following Institutional Review Board approval, an adapted version of the Care Coordination Measurement Tool (CCMT) was used to collect data prospectively on non-billable activities performed by a psychologist, social worker (SW), and certified child life specialist (CCLS) in a pediatric urology department. Variables included activity type, time spent per activity, and outcomes affected. Demographic data included age, sex, race, state, zip code, insurance type, and language. From April to October 2022, 3096 activities were performed in support of psychosocial needs over 947 encounters for 527 patients. The median patient age was 9.2 years (IQR 4.8–12.4); 48.4 % were male. The psychosocial providers most commonly identified care coordination needs related to delivery of urologic care (73.4 %), mental/behavioral/developmental health (29.1 %), and referral and appointment management (19.9 %). The largest proportion of time was spent on providing direct psychosocial support (45.9 %), consisting of psychosocial assessments, education, and other behavioral health interventions. A large proportion of time was also spent on care coordination activities, namely logistics and navigation support (35.9 %). Relative time allocation across activities varied by provider type (p