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J Pediatr. 2016 Feb;169:291-6.e1. doi: 10.1016/j.jpeds.2015.10.010. Epub 2015 Oct 31.

Health Services and Health Care Needs Fulfilled by Structured Clinical Programs for Children with Medical Complexity.

Author information

1
Center for Applied Research and Evaluation, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR; Arkansas Children's Hospital Research Institute, Little Rock, AR. Electronic address: dzkuo@uams.edu.
2
Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.
3
Institute of Medicine, Washington, DC.
4
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.

Abstract

OBJECTIVE:

To describe family-reported health service needs of children with medical complexity (CMC) and to assess which needs are more often addressed in a tertiary care center-based structured clinical program for CMC.

STUDY DESIGN:

Mailed survey to families of CMC enrolled in a structured-care program providing care coordination and oversight at 1 of 3 children's hospitals. Outcomes included receipt of 14 specific health service needs. Paired t tests compared unmet health care needs prior to and following program enrollment.

RESULTS:

Four hundred forty-one of 968 (46%) surveys were returned and analyzed. Respondents reported their children had a mean age of 7 (SD 5) years. A majority of respondents reported the child had developmental delay (79%) and feeding difficulties (64%). Of the respondents, 56% regarded the primary care provider as the primary point of contact for medical issues. Respondents reported an increase in meeting all 14 health services needs after enrollment in a tertiary care center-based structured clinical program, including primary care checkups (82% vs 96%), therapies (78% vs 91%), mental health care (34% vs 58%), respite care (56% vs 75%), and referrals (51% vs 83%) (all P < .001).

CONCLUSIONS:

Tertiary care center-based structured clinical care programs for CMC may address and fulfill a broad range of health service needs that are not met in the primary care setting.

PMID:
26526361
PMCID:
PMC4729644
DOI:
10.1016/j.jpeds.2015.10.010
[Indexed for MEDLINE]
Free PMC Article

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