Health Services and Health Care Needs Fulfilled by Structured Clinical Programs for Children with Medical Complexity. J Pediatr 2016 Feb;169:291-6.e1
Date
11/04/2015Pubmed ID
26526361Pubmed Central ID
PMC4729644DOI
10.1016/j.jpeds.2015.10.010Scopus ID
2-s2.0-84959281589 (requires institutional sign-in at Scopus site) 76 CitationsAbstract
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.
Author List
Kuo DZ, Berry JG, Glader L, Morin MJ, Johaningsmeir S, Gordon JMESH terms used to index this publication - Major topics in bold
AdolescentChild
Child Health Services
Child, Preschool
Developmental Disabilities
Female
Health Services Needs and Demand
Humans
Male
Surveys and Questionnaires
Tertiary Care Centers