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Observational Study
. 2019 Sep 18;19(1):673.
doi: 10.1186/s12913-019-4524-0.

Waiting times for diagnosis of attention-deficit hyperactivity disorder in children and adolescents referred to Italian ADHD centers must be reduced

Maurizio Bonati  1 , Massimo Cartabia  2 , Michele Zanetti  2 ; Lombardy ADHD Group
Collaborators, Affiliations
Observational Study

Waiting times for diagnosis of attention-deficit hyperactivity disorder in children and adolescents referred to Italian ADHD centers must be reduced

Maurizio Bonati et al. BMC Health Serv Res. .

Abstract

Background: 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.

Methods: Data 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.

Results: The 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.

Conclusions: To 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.

Keywords: Attention-deficit hyperactivity disorder; Children; Epidemiology; Health service; Italy; Waiting time.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors declare no financial relationships with any organizations that might have an interest in the submitted work; no other relationships or activities that could appear have influenced the submitted work.

Figures

Fig. 1
Fig. 1
Euclidian distances between house of residence and accessed ADHD center. The map of Lombardy Region is divided according to the 8 ATS
Fig. 2
Fig. 2
Time from request to diagnosis (days) by ADHD center. Observed (•) and estimated according to a generalized linear model (GLM) analysis (◊) values (mean, CI 95%)
Fig. 3
Fig. 3
Distribution of ADHD centres by waiting time from the request to the diagnosis, the hours/year of work for ADHD, and the number of children and adolescents with ≥1 access per year. Mean (─), CI 95% (---). Footnotes: The size of circles is proportional to the number of children and adolescents per center included in the study. Pearson’s chi-squared test: ρ = 0.11; p-value = 0.6624; weighted Pearson’s chi-squared: ρ = − 0.10; p-value = 0.6789; Spearman’s rank correlation test: ρ = 0.01; p = 0.9838
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