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Social Work Services Utilization by Children with Medical Complexity.

Madeline Coquillette1, Joanne E Cox2, Sara Cheek3

  • 1Division of General Pediatrics, Department of Medicine, Children's Hospital Primary Care Center, Boston Children's Hospital, 300 Longwood Avenue, Hunnewell Ground Floor, Boston, MA, 02115, USA. madeline.coquillette@childrens.harvard.edu.

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Children with medical complexity (CMC) utilize significantly more social work services than other children. This highlights the need for enhanced family-centered care models in pediatric primary care settings.

Keywords:
Children with special health care needsMedical complexityMedical homePrimary careSocial work

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Area of Science:

  • Pediatric Healthcare
  • Social Work Services
  • Health Services Research

Background:

  • Children with medical complexity (CMC) present unique challenges for families and healthcare systems.
  • There is a growing need to understand resource utilization for CMC to develop effective support systems.

Purpose of the Study:

  • To quantify and compare hospital-wide social work services utilization between CMC and non-medically-complex children (non-CMC).
  • To inform the development of family-centered care models for vulnerable pediatric populations.

Main Methods:

  • A retrospective analysis of social work department records from a tertiary children's hospital.
  • Comparison of CMC (n=564) and age/sex-matched non-CMC (n=1128) over 16 months.
  • Outcome measures included service utilization proportion and mean hours per patient.

Main Results:

  • CMC showed significantly higher social work service utilization (60.3% vs. 18.9%) and hours per child (5.50 vs. 0.69).
  • Medical complexity independently predicted greater odds of service use and higher service hours (odds ratio 6.23, 8.07 times more hours).

Conclusions:

  • Children with medical complexity demonstrate substantially higher use of social work services within the medical setting.
  • Findings underscore the necessity of integrating comprehensive social work support into proactive medical home models for CMC.
  • Further research is warranted to identify specific drivers of social work service utilization in this population.