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[Clinical complexity and need for palliative care in non-oncological patients with special health care needs]

Romina Espinoza Núñez1, Carlos Valdebenito Parra1, Antonio Huerta-Armijo1

  • 1Sociedad Chilena de Pediatría, Santiago, Chile.

Andes Pediatrica : Revista Chilena De Pediatria
|March 17, 2026
PubMed

Insights

Clinical complexity in Children and Youth with Special Health Care Needs (CYSHCN) strongly correlates with the need for pediatric palliative care (PPC). High-complexity CYSHCN patients particularly require intensified PPC services.

Area of Science:

  • Pediatrics
  • Palliative Care
  • Healthcare Management

Background:

  • Categorizing the complexity of Children and Youth with Special Health Care Needs (CYSHCN) can inform pediatric palliative care (PPC) needs.
  • Previous studies have not evaluated the association between clinical complexity and PPC requirements in CYSHCN.

Purpose of the Study:

  • To evaluate the association between clinical complexity and the requirement for PPC in CYSHCN.
  • To determine if complexity levels predict the need for and intensity of PPC.

Main Methods:

  • An observational, cross-sectional study was conducted with 70 CYSHCN patients.
  • Patients were classified by complexity (low, medium, high) and assessed for PPC needs using the Paediatric Palliative Screening Scale (PaPaS Scale).

Main Results:

  • A strong positive correlation (Pearson r = 0.8225) was found between clinical complexity and the need for PPC.
  • 65.7% of patients were high-complexity, and 65.7% required PPC; all high-complexity patients needed PPC.
  • No patients required PPC in the low-complexity group.

Conclusions:

  • A significant correlation exists between clinical complexity and the need for PPC in CYSHCN.
  • High-complexity CYSHCN patients are more likely to require intensified palliative care.
  • Complexity assessment is crucial for guiding PPC provision in CYSHCN.

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