Comparison of specialist and nonspecialist care pathways for adolescents with anorexia nervosa and related eating disorders

Objective: To explore the role of specialist outpatient eating disorders services and investigate how direct access to these affects rates of referral, admissions for inpatient treatment, and continuity of care. Method: Services beyond primary care in Greater London retrospectively identified adolescents who presented with an eating disorder over a 2-year period. Data concerning service use were collected from clinical casenotes. Results: In areas where specialist outpatient services were available, 23 times more cases were identified than in areas without such services. Where initial outpatient treatment was in specialist rather than nonspecialist services, there was a significantly lower rate of admission for inpatient treatment and considerably higher consistency of care. Discussion: Developing specialist outpatient services with direct access from primary care is likely to lead to improvements in treatment and reduce overall costs. (c) 2012 by Wiley Periodicals, Inc.