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Care coordination for children with medical complexity
Mary Ann de Banate1, Jack Maypole2, Matthew Sadof1
1Boston University School of Medicine.
Insights
Identifying, coordinating, and funding care for children with medical complexity requires effective strategies. Understanding family and provider needs is crucial for improving care coordination for these medically fragile youth.
Area of Science:
- Pediatric Healthcare
- Health Services Research
- Care Coordination
Background:
- Children with medical complexity represent a high-cost, medically fragile subpopulation of youth with special healthcare needs.
- Effective identification, coordination, and funding of care are critical for this group.
- Existing literature provides insights into the latest approaches for managing their healthcare.
Purpose of the Study:
- To review the literature on best practices for identifying, coordinating, and funding care for children with medical complexity.
- To synthesize current understanding of the needs of families and healthcare providers.
- To inform the development of new technologies and measures for care coordination.
Main Methods:
- Literature review of existing studies on children with medical complexity.
- Analysis of research on family and healthcare provider perspectives.
- Examination of algorithms for identifying this population.
Main Results:
- Algorithms exist for identifying children with medical complexity.
- Key components of effective care coordination include strong family partnerships and adequate resources.
- Care coordination is a team-based approach with consistent findings across studies regarding structure, staffing, and costs.
- Funding models are available and adaptable to different settings.
Conclusions:
- Effective care coordination significantly benefits children with medical complexity.
- Enhanced understanding of family and provider needs will drive innovation in care management.
- Tailored funding and coordinated team efforts are essential for optimal outcomes.
Purpose Of Review:
We review the literature to help the reader better understand the latest thinking on how best to identify, coordinate and fund care for children with medical complexity, a medically fragile high-cost subpopulation of children and youth with special healthcare needs.
Recent Findings:
Proprietary and public algorithms have been developed to identify children with medical complexity. Research on families and healthcare providers of children with medical complexity have identified essential components of effective care coordination. Calculation of the cost of care for this population is confounded by cost shifting to families and the variable course of illness in this heterogeneous high-cost population. Care coordination is a team sport that requires strong family partnerships, adequate time and resources to be done effectively. Multiple studies of different sizes have reported similar care coordination team structure, staffing ratios and cost ranges. Multiple options for funding this work now exist and can be tailored to individual environments.
Summary:
Effective care coordination can positively impact the care of children with medical complexity. Recent work resulting in a better understanding of the needs of families and providers will guide the development of new technologies and measures.
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