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Ways to Identify Children with Medical Complexity and the Importance of Why

2015; Elsevier BV; Volume: 167; Issue: 2 Linguagem: Inglês

10.1016/j.jpeds.2015.04.068

1097-6833

Jay G. Berry, Matt Hall, Eyal Cohen, Margaret O’Neill, Chris Feudtner,

Childhood Cancer Survivors' Quality of Life

Children with medical complexity, although a small fraction of the pediatric population, are important due to their high levels of healthcare spending, unmet healthcare needs, substandard quality of care, and poor health outcomes. 1 Cohen E. Kuo D.Z. Agrawal R. Berry J.G. Bhagat S.K. Simon T.D. et al. Children with medical complexity: an emerging population for clinical and research initiatives. Pediatrics. 2011; 127: 529-538 Crossref PubMed Scopus (608) Google Scholar Consistent with the Triple Aim, 2 The IHI Triple Aim [Internet]. Cambridge, MA; c2015. Institute for Healthcare Improvement. http://www.ihi.org/Engage/Initiatives/TripleAim. Accessed March 2, 2015. Google Scholar these children are the focus of clinical, research, and policy initiatives seeking to: (1) improve their healthcare experience and quality of care; (2) improve outcomes (for themselves and their families); and (3) reduce the future healthcare costs that they might accrue. 3 Kuo D.Z. Cohen E. Agrawal R. Berry J.G. Casey P. A national profile of caregiver challenges of more-complex children with special healthcare needs. Arch Pediatr Adolesc Med. 2011; 165: 1020-1026 Crossref PubMed Scopus (291) Google Scholar , 4 Berry J.G. Agrawal R. Kuo D.Z. Cohen E. Risko W. Hall M. et al. Characteristics of hospitalizations for patients who use a structured clinical care program for children with medical complexity. J Pediatr. 2011; 159: 284-290 Abstract Full Text Full Text PDF PubMed Scopus (116) Google Scholar , 5 Cohen E. Jovcevska V. Kuo D.Z. Mahant S. Hospital-based comprehensive care programs for children with special healthcare needs: a systematic review. Arch Pediatr Adolesc Med. 2011; 165: 554-561 Crossref PubMed Scopus (59) Google Scholar , 6 Gordon J.B. Colby H.H. Bartelt T. Jablonski D. Krauthoefer M.L. Havens P. A tertiary care-primary care partnership model for medically complex and fragile children and youth with special healthcare needs. Arch Pediatr Adolesc Med. 2007; 161: 937-944 Crossref PubMed Scopus (155) Google Scholar , 7 Casey P. Lyle R.E. Bird T.M. Robbins J.M. Kuo D.Z. Brown C. et al. Effect of hospital-based comprehensive care clinic on health costs for Medicaid-insured medically complex children. Arch Pediatr Adolesc Med. 2011; 165: 392-398 Crossref PubMed Scopus (88) Google Scholar , 8 Klitzner T.S. Rabbitt L.A. Chang R.K. Benefits of care coordination for children with complex disease: a pilot medical home project in a resident teaching clinic. J Pediatr. 2010; 156: 1006-1010 Abstract Full Text Full Text PDF PubMed Scopus (79) Google Scholar Clinics, hospitals, states, and countries throughout the world are reforming the health system to optimize its performance for children with medical complexity. 9 Health Care Innovation Awards Round Two [Internet]. Baltimore, MD; c2014. Centers for Medicare and Medicaid Services. http://innovation.cms.gov/initiatives/Health-Care-Innovation-Awards/Round-2.html. Accessed March 2, 2015. Google Scholar , 10 Optimizing the Role of Complex Continuing Care and Rehabilitation in the Transformation of the Health Care Delivery System [Internet]. Ontario Hospital Association, Toronto, ON2006https://www.oha.com/CurrentIssues/keyinitiatives/eHealth/Documents/Optimizing_the_Role_of_CCCandRehab.pdf Google Scholar