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Paediatr Child Health. 2013 Dec;18(10):518-22.

Children with medical complexity in Canada.

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Division of General Pediatrics, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, British Columbia;
Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto; ; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto; ; CanChild Center for Childhood Disability Research, Hamilton, Ontario.


in English, French

The burden of chronic disease is placing pressure on the Canadian health care system. A small but important chronic disease population is children with medical complexity, defined as individuals with: high family-identified needs; complex chronic disease necessitating specialized care; functional disability; and high health care utilization. These patients present a challenge to community providers who are expected to provide holistic care and manage complex issues, often with a paucity of services and supports. Alternative models of care may address the complex needs of this population. In addition, strategies can be implemented in community practices that may assist with the care of children with medical complexity such as collaborative care, engagement of key workers, focus on goal-directed care and use of care plans. The paediatric community should engage in health care reform discussions focused on chronic disease to ensure that the complex needs of these children are met.


Canada; Children; Children with medical complexity; Complex disorders; Guidance; Health care reform


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