What Does Care Coordination Do? Profiling a Large Telephone-based 211 Program Serving Young Children.

Area of Science:

• Pediatric Health Services Research
• Developmental Pediatrics
• Health Services Management

Background:

• Care coordination is crucial for transitioning children from screening to services, yet its definition and data are limited, especially for autism and developmental delays.
• This ambiguity can create unrealistic healthcare system expectations regarding coordination feasibility.
• 211 LA, a telephone-based program, demonstrated improved service receipt for early intervention and developmental support in a prior randomized trial.

Purpose of the Study:

• To characterize the nature, cost, and effectiveness of care coordination activities within the 211 LA program.
• To analyze the relationship between coordination efforts and service receipt for children with autism and developmental delays.

Main Methods:

• Retrospective cohort analysis of administrative data from 211 LA's care coordination intervention group.
• Examined logged coordinator contacts (time, method, party) for children screened for autism and developmental delays.
• Assessed coordination costs and explored the link between coordination activities and subsequent service receipt.

Main Results:

• The 211 LA program involved 274 children, averaging 19.0 contacts per case over a 17.2-month engagement period.
• High-risk children received significantly more contacts (30.8) than low-risk children (14.2).
• A higher number of service provider referrals was associated with receiving services, but total contact frequency was not.

Conclusions:

• Telephone-based care coordination for children with autism/developmental delays involves substantial coordinator time and engagement.
• Service provider referrals, a specific coordination outcome, showed a significant relationship with service receipt.
• The study highlights the need for nuanced metrics beyond total contact counts to evaluate care coordination effectiveness.