A Home for Medically Complex Children: The Role of Hospital Programs

Cohen, Eyal; Friedman, Jeremy; Nicholas, David; Adams, Sherri; Rosenbaum, Peter

doi:10.1111/j.1945-1474.2008.tb01137.x

Cited by 34 publications

(29 citation statements)

References 42 publications

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“…46 Applying a medical home model to the inpatient setting with coordination and communication between hospital caregivers, primary care providers, and specialists is challenging but has been suggested as beneficial to the child, the hospital, and caregivers. 47,48 Additional research should confirm the value of a hospitalbased medical home.…”

Section: Figurementioning

confidence: 99%

Increasing Prevalence of Medically Complex Children in US Hospitals

et al. 2010

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OBJECTIVE: In this study we used national data to determine changes in the prevalence of hospital admissions for medically complex children over a 15-year period. PATIENTS AND METHODS: Data from the Nationwide Inpatient Sample, a component of the Healthcare Cost and Utilization Project, was analyzed in 3-year increments from 1991 to 2005 to determine national trends in rates of hospitalization of children aged 8 days to 4 years with chronic conditions. Discharge diagnoses from the Nationwide Inpatient Sample were grouped into 9 categories of complex chronic conditions (CCCs). Hospitalization rates for each of the 9 CCC categories were studied both individually and in combination. Trends of children hospitalized with 2 specific disorders, cerebral palsy (CP) and bronchopulmonary dysplasia, with additional diagnoses in more than 1 CCC category were also examined. RESULTS: Hospitalization rates of children with diagnoses in more than 1 CCC category increased from 83.7 per 100 000 (1991–1993) to 166 per 100 000 (2003–2005) (P[r] < .001). The hospitalization rate of children with CP plus more than 1 CCC diagnosis increased from 7.1 to 10.4 per 100 000 (P = .002), whereas the hospitalization rates of children with bronchopulmonary dysplasia plus more than 1 CCC diagnosis increased from 9.8 to 23.9 per 100 000 (P < .001). CONCLUSIONS: Consistent increases in hospitalization rates were noted among children with diagnoses in multiple CCC categories, whereas hospitalization rates of children with CP alone have remained stable. The relative medical complexity of hospitalized pediatric patients has increased over the past 15 years.

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Section: Figurementioning

confidence: 99%

Increasing Prevalence of Medically Complex Children in US Hospitals

et al. 2010

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“…Given that children with chronic conditions, including asthma, now account for a majority of hospital discharges, 28 inpatient care and discharge models that reliably target clinical and social risks are critical. [29][30][31] Although primary care-community collaboration has grown, 32-34 inpatient-community collaboration is uncommon but could help target such risks and, potentially, reduce morbidity.…”

Section: Discussionmentioning

confidence: 99%

Connecting At-Risk Inpatient Asthmatics to a Community-Based Program to Reduce Home Environmental Risks: Care System Redesign Using Quality Improvement Methods

Beck

Simmons

Sauers³

et al. 2013

Hospital Pediatrics

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“…Coordinated managed care of MCCs can improve outcomes and reduce healthcare costs. 10,11 Furthermore, forecasting the numbers of MCCs and other patient groups can enable predictions of hospital occupancy, economic resource utilization, and outcomes. [12][13][14] Identifying MCCs at admission can guide treatment decisions, psychosocial interventions, and strategic planning at institutional and governmental levels.…”

Section: Introductionmentioning

confidence: 99%

Predictive Analytics In Healthcare:Medications as a Predictor of Medical Complexity

Higdon¹,

Stewart²,

Roach

et al. 2013

Big Data

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Children with special healthcare needs (CSHCN) require health and related services that exceed those required by most hospitalized children. A small but growing and important subset of the CSHCN group includes medically complex children (MCCs). MCCs typically have comorbidities and disproportionately consume healthcare resources. To enable strategic planning for the needs of MCCs, simple screens to identify potential MCCs rapidly in a hospital setting are needed. We assessed whether the number of medications used and the class of those medications correlated with MCC status. Retrospective analysis of medication data from the inpatients at Seattle Children's Hospital found that the numbers of inpatient and outpatient medications significantly correlated with MCC status. Numerous variables based on counts of medications, use of individual medications, and use of combinations of medications were considered, resulting in a simple model based on three different counts of medications: outpatient and inpatient drug classes and individual inpatient drug names. The combined model was used to rank the patient population for medical complexity. As a result, simple, objective admission screens for predicting the complexity of patients based on the number and type of medications were implemented.

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A Home for Medically Complex Children: The Role of Hospital Programs

Cited by 34 publications

References 42 publications

Increasing Prevalence of Medically Complex Children in US Hospitals

Increasing Prevalence of Medically Complex Children in US Hospitals

Connecting At-Risk Inpatient Asthmatics to a Community-Based Program to Reduce Home Environmental Risks: Care System Redesign Using Quality Improvement Methods

Predictive Analytics In Healthcare:Medications as a Predictor of Medical Complexity

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