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Guidelines for the care of the child with special health care needs
Edward Goldson1, Glenda Louch, Kimberly Washington
1Department of Pediatrics, University of Colorado Medical School, The Children's Hospital, 1056 E. 19th Avenue, Denver, CO 80218, USA. goldson.edward@tchden.org
Insights
Children with Special Health Care Needs (CSHCN) require specialized care. Establishing a multidisciplinary medical home offers a promising approach to improve health care delivery for these medically complex children.
Area of Science:
- Pediatric Healthcare
- Healthcare Management
- Public Health
Background:
- Children with Special Health Care Needs (CSHCN) are medically complex and require extensive services, significantly impacting pediatric healthcare budgets.
- The organization of clinical settings plays a crucial role in delivering effective care to this diverse patient group.
- CSHCN represent a growing population due to advancements in medical technology and care.
Purpose of the Study:
- To articulate the philosophical principles behind a specific clinic model (SCC) designed for CSHCN.
- To explore the establishment of a multidisciplinary medical home as a strategy for serving CSHCN.
- To identify common medical issues in CSHCN and propose management strategies.
Main Methods:
- The article describes the organizational philosophy of the Special Care Clinic (SCC) within an academic tertiary care center.
- It outlines strategies for addressing common medical problems encountered in CSHCN.
- The study discusses the ethical considerations of providing care within a medical home framework.
Main Results:
- A multidisciplinary medical home with a non-categorical approach is presented as a viable model for CSHCN care.
- Common medical challenges faced by CSHCN and corresponding management approaches are identified.
- The study emphasizes the need for increased resources and a shift in perspective towards respecting CSHCN as individuals.
Conclusions:
- Establishing a medical home with a non-categorical approach is a key step towards comprehensive care for CSHCN.
- Healthcare providers must develop resources and adapt care models to meet the increasing needs of this population.
- A fundamental change in addressing CSHCN and their families, ensuring equal care, concern, and respect, is essential.
Abstract:
CSHCN present a challenge to the primary care provider. These children are medically complex, require services and supports well beyond those that typically developing children require, and command a considerable proportion of the pediatric health care budget. How clinics are organized can have a considerable impact on the delivery of care to this heterogeneous group of complicated children. In this article, the authors articulate the philosophic underpinnings of one clinic-the SCC-located in an academic tertiary care center. Establishing a multidisciplinary medical home with a noncategoric approach to health care is one way of serving patients who have special health care needs. The more common medical problems encountered in the SCC are identified, along with strategies to address them. The ethics of caring for CSHCN are complex and controversial and have only been touched on in the context of providing a medical home. It is clear that CSHCN are going to increase in numbers as technology and medical care change. Thus, it is incumbent on child health care providers to develop resources to meet the needs of this complicated population. There needs to be a change in the way CSHCN and their families are addressed, accepting them as individuals worthy of the same care, concern, and respect that typically developing children receive. The establishment of a medical home with a noncategoric approach to care may be one step in achieving comprehensive care for this population of underserved children.
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