Association of Care Coordination Experience and Health Services Use with Main Provider Type for Children with IBD.

Objectives To describe care coordination experience for families of children with IBD and compare use of health services between families who identified a primary care physician (PCP) versus gastroenterologist as a child’s main provider. Study design Cross-sectional survey of care coordination experience and health services use for children 6-19 years old receiving care in the IBD program at a children’s hospital during 2018. English-speaking parents completed the Family Experiences with Coordination of Care (FECC) Survey about their child’s “main provider” and reported past-year health services. Bivariate testing and multivariate logistic regression explored differences in care coordination experience and health services by main provider, adjusted for demographic and clinical variables. Results A total of 113 of 270 (42%) invited subjects participated. Among 101 subjects with complete data, 41% identified a PCP main provider. Performance on 5 of 16 FECC indicators was higher for patients reporting a GI vs PCP main provider. However, having a PCP vs GI main provider was associated with higher use of any past-year primary care services (adjusted proportion 94% vs 75%, p=0.01) and of mental health services when needed (95% vs 60%, P Conclusions Children with IBD may experience trade-offs in care coordination quality and important, non disease-focused health services based on whom parents perceive as the main provider. Efforts to enhance cross-team coordination among families and primary and specialty care teams are needed to improve overall care quality.