Care Models and Discharge Services for Children With Medical Complexity

Area of Science:

• Pediatric Healthcare
• Health Services Research
• Care Management

Background:

• Children with medical complexity (CMC) are significant healthcare users, necessitating specialized care models.
• Existing care models for CMC have not been evaluated nationally.
• Hospital-based care models aim to improve outcomes for high-utilizing pediatric populations.

Purpose of the Study:

• To describe the structure and presence of care models for CMC.
• To assess the utilization of discharge services for CMC.
• To analyze national practices in freestanding children's hospitals.

Main Methods:

• An electronic survey was sent to 48 hospitals in the Pediatric Health Information System.
• Hospitals reported on the types and number of care models for CMC.
• Discharge services were categorized by frequency of use: low, medium, and high.

Main Results:

• 33 out of 48 (69%) hospitals responded, with no significant differences from non-responders.
• A majority (67%) reported outpatient care models; 21% lacked dedicated CMC care models.
• High-frequency discharge services included DME delivery, medication delivery, and pre-discharge provider communication.

Conclusions:

• Significant variation exists in care model structures and discharge services for CMC across children's hospitals.
• Further research is required to link care models and discharge services to healthcare outcomes for CMC.
• The findings highlight the need for standardized and evaluated care coordination strategies for this population.