Care Coordination Programs for Infants With Complex Conditions: A Systematic Review

Vance, Ashlee; Benjamin, Annella; Hsu, Jessica; Berry, Jay G.

doi:10.1542/peds.2022-061083

Cited by 3 publications

(1 citation statement)

References 32 publications

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“…Many programs began using telehealth platforms for follow-up care during the COVID-19 pandemic [27,28]. A recent systematic review found that care coordination for infants with complex care needs reduces costs for families and health systems and leads to improved care quality [29].…”

Section: Overview Of Clinical High-risk Infant Follow-up Carementioning

confidence: 99%

Ensuring Optimal Outcomes for Preterm Infants after NICU Discharge: A Life Course Health Development Approach to High-Risk Infant Follow-Up

Litt,

Halfon,

Msall

et al. 2024

Children

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Children born prematurely (<37 weeks’ gestation) have an increased risk for chronic health problems and developmental challenges compared to their term-born peers. The threats to health and development posed by prematurity, the unintended effects of life-sustaining neonatal intensive care, the associated neonatal morbidities, and the profound stressors to families affect well-being during infancy, childhood, adolescence, and beyond. Specialized clinical programs provide medical and developmental follow-up care for preterm infants after hospital discharge. High-risk infant follow-up, like most post-discharge health services, has many shortcomings, including unclear goals, inadequate support for infants, parents, and families, fragmented service provisions, poor coordination among providers, and an artificially foreshortened time horizon. There are well-documented inequities in care access and delivery. We propose applying a life course health development framework to clinical follow-up for children born prematurely that is contextually appropriate, developmentally responsive, and equitably deployed. The concepts of health development, unfolding, complexity, timing, plasticity, thriving, and harmony can be mapped to key components of follow-up care delivery to address pressing health challenges. This new approach envisions a more effective version of clinical follow-up to support the best possible functional outcomes and the opportunity for every premature infant to thrive within their family and community environments over their life course.

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Section: Overview Of Clinical High-risk Infant Follow-up Carementioning

confidence: 99%

Ensuring Optimal Outcomes for Preterm Infants after NICU Discharge: A Life Course Health Development Approach to High-Risk Infant Follow-Up

Litt,

Halfon,

Msall

et al. 2024

Children

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Health care utilization after enrollment in an outpatient structured clinical program for children with medical complexity

Cook,

Hall,

Stringfellow

et al. 2024

Paediatrics &Amp; Child Health

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Objectives Although children with medical complexity (CMC) with high health resource utilization use outpatient structured clinical programs (SCP) to optimize their health, little is known about variation in trends of their health service use shortly after enrollment. We measured these trends and assessed the utility of patient characteristics to predict them. Methods Retrospective analysis of 506 CMC newly enrolled in an outpatient, academic SCP. We measured outpatient and inpatient health service use for the first 6 months following enrollment. Using cluster analysis, we categorized CMC with similar trends by health service. We assessed patient demographic (e.g., age) and clinical [type and number of complex chronic conditions (CCC)] characteristics with the cluster categories. Results Most (90.3%) CMC enrolled had ≥1 CCCs; 53.8% had ≥3 CCCs. For all CMC, outpatient specialty visits, phone calls, and hospitalizations (not involving ICU) decreased significantly over the first 6 months after enrollment. For example, the hospitalization rate decreased from 9.7% to 4.5% in the 1st and 6th months, respectively, (P < 0.001). Cluster analysis revealed four categories of hospitalization trends, 6 months after enrollment: 72.9% of CMC had no hospital use; 16.0% had increased then decreased use; 8.3% had decreased use; and 2.8% had increased use. No patient and clinical characteristics clearly distinguished which hospitalization trend CMC experienced. Conclusions Although the overall population of CMC experienced decreased outpatient and inpatient health services utilization over time, this decrease was not uniformly experienced. Fundamental patient demographic and clinical characteristics did not predict health service trends.

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Aplicabilidade Da Teoria De Orem No Autocuidado De Crianças Dependentes De Tecnologias

Da Costa Alves Delmiro,

Moreira,

Rocha

et al. 2024

Rev. Enferm. Atual In Derme

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Objetivo: Refletir sobre os conceitos da Teoria Geral do Autocuidado de Orem e o cuidado de crianças dependentes de tecnologias. Método: Trata-se de estudo teórico-reflexivo, de natureza interpretativa, realizado em duas etapas: 1) revisão narrativa da literatura sobre a temática e os conceitos das teorias desenvolvidas por Orem e 2) relação entre as teorias e o cuidado às crianças dependentes de tecnologias. Resultados: Durante a assistência, o processo de autocuidado está diretamente associado às demandas de saúde do binômio criança-família. A teoria geral do autocuidado de Orem é composta por três segmentos os quais podem ser entrelaçados ao cuidado às crianças dependentes de tecnologias. Durante a assistência às crianças dependentes de tecnologias, o processo de autocuidado está diretamente associado às demandas de saúde do binômio crianças dependentes de tecnologias e família. Conclusão: As teorias desenvolvidas por Orem permitem aos profissionais de Enfermagem nortear a assistência com ações voltadas para a promoção do autocuidado do binômio criança-família.

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Care Coordination Programs for Infants With Complex Conditions: A Systematic Review

Cited by 3 publications

References 32 publications

Ensuring Optimal Outcomes for Preterm Infants after NICU Discharge: A Life Course Health Development Approach to High-Risk Infant Follow-Up

Ensuring Optimal Outcomes for Preterm Infants after NICU Discharge: A Life Course Health Development Approach to High-Risk Infant Follow-Up

Health care utilization after enrollment in an outpatient structured clinical program for children with medical complexity

Aplicabilidade Da Teoria De Orem No Autocuidado De Crianças Dependentes De Tecnologias

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