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Pediatric Population Management Classification for Children with Medical Complexity.

Christian D Pulcini1, Xianqun Luan2, Elizabeth S Brooks2

  • 1Department of Emergency Medicine & Pediatrics, University of Vermont Larner College of Medicine, Burlington, Vermont, USA.

Population Health Management
|April 13, 2024
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Summary
This summary is machine-generated.

A new Pediatric Population Management Classification (PPMC) system accurately identifies children with medical complexity (CMC) who have high healthcare utilization. This approach aids in proactive clinical management and quality improvement for these vulnerable pediatric populations.

Keywords:
chronic diseasepediatricspopulation health

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Area of Science:

  • Pediatric healthcare
  • Health informatics
  • Population health management

Background:

  • Identifying children with medical complexity (CMC) for targeted care is challenging.
  • Existing methods may not effectively capture sustained, high healthcare utilization.
  • Proactive identification is crucial for quality improvement initiatives.

Purpose of the Study:

  • To develop and validate a new system, the Pediatric Population Management Classification (PPMC), for identifying CMC.
  • To compare the PPMC system with the Complex Chronic Conditions (CCC) system.
  • To assess the ability of PPMC to capture longitudinal risk for elevated healthcare utilization.

Main Methods:

  • Utilized real-time electronic health record (EHR) data from a tristate health system.
  • Developed the PPMC based on visit diagnoses and problem lists.
  • Compared PPMC with the CCC system using weighted kappa statistics for agreement and persistence of high charges/utilization (2016-2019).

Main Results:

  • The PPMC system demonstrated higher precision in identifying CMC with persistently high utilization and charges, particularly within primary care settings.
  • Agreement between PPMC and CCC was lower in primary care populations (weighted κ 62%) compared to specialty/hospital-only populations (weighted κ 82%).
  • PPMC showed greater accuracy in capturing sustained high utilization among children receiving primary care.

Conclusions:

  • The PPMC classification scheme offers a more pragmatic approach for selecting children with CMC for longitudinal care management.
  • The PPMC system shows promise for improving proactive identification and management of high-risk pediatric populations.
  • Real-time EHR data and refined classification systems are vital for effective population health management in pediatrics.