The Effect of a Comprehensive Care Transition Model on Cost and Utilization for Medically Complex Children With Cerebral Palsy

Howard, Steven W.; Zhang, Zidong; Buchanan, Paula; Armbrecht, Eric S.; Williams, Caitlin R.; Wilson, Geneva; Hutchinson, Janna; Pearson, Lindsey; Ellsworth, Samantha; Byler, Caitlin M.; Loux, Travis; Wang, Jing; Bernell, Steph; Holekamp, Nicholas

doi:10.1016/j.pedhc.2017.04.017

Cited by 19 publications

(18 citation statements)

References 21 publications

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“…Some researchers estimate that up to 30% of pediatric readmissions might be preventable; 3,8,9 others indicate that up to 79.3% reduction can be achieved among patients with asthma 10 and 66% in medically complex children with cerebral palsy. 11 Other researchers have addressed interventions that could help in reducing pediatric readmissions. [8][9][10][11][12][13] Although there is a paucity of prediction models for pediatric readmission, some researchers have shown promise in the use of prediction models in identifying pediatric patients at high risk of readmission.…”

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confidence: 99%

“…11 Other researchers have addressed interventions that could help in reducing pediatric readmissions. [8][9][10][11][12][13] Although there is a paucity of prediction models for pediatric readmission, some researchers have shown promise in the use of prediction models in identifying pediatric patients at high risk of readmission. [14][15][16][17][18] In this study, we focus on 5 sets of generally known and potential risk factors of readmission, including demographics and social determinants of health, hospital resource use variables, disease diagnosis groups, severity of disease or medical complexities, and the pediatric Rothman Index (pRI) variables.…”

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confidence: 99%

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A Novel Model for Enhanced Prediction and Understanding of Unplanned 30-Day Pediatric Readmission

Ehwerhemuepha

Finn²,

Rothman

et al. 2018

Hospital Pediatrics

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Our model provides significant performance improvements in the prediction of unplanned 30-day pediatric readmissions with AUC higher than the LACE readmission model and other general unplanned 30-day pediatric readmission models. The model is expected to provide an opportunity to capture 39% of readmissions (at a selected operating point) and may therefore assist clinicians in reducing avoidable readmissions.

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confidence: 99%

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confidence: 99%

A Novel Model for Enhanced Prediction and Understanding of Unplanned 30-Day Pediatric Readmission

Ehwerhemuepha

Finn²,

Rothman

et al. 2018

Hospital Pediatrics

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“…Prevention is a critical strategy for cost-effectiveness [33]. A study by Ranken Jordan Pediatric Bridge Hospital demonstrated that intensive care coordination, psychosocial therapy, family and caregiver empowerment, and transitional care might alleviate costs and unnecessary hospital stays among children with CP [34].…”

Section: Discussionmentioning

confidence: 99%

Continuity of Care Is Associated with Medical Costs and Inpatient Days in Children with Cerebral Palsy

Yang

Yin

Hung

et al. 2020

IJERPH

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Background: Children with cerebral palsy (CP) place a considerable burden on medical costs and add to an increased number of inpatient days in Taiwan. Continuity of care (COC) has not been investigated in this population thus far. Materials and Methods: We designed a retrospective population-based cohort study using Taiwan's National Health Insurance Research Database. Patients aged 0 to 18 years with CP catastrophic illness certificates were enrolled. We investigated the association of COC index (COCI) with medical costs and inpatient days. We also investigated the possible clinical characteristics affecting the outcome. Results: Over five years, children with CP with low COCI levels had higher medical costs and more inpatient days than did those with high COCI levels. Younger age at CP diagnosis, more inpatient visits one year before obtaining a catastrophic illness certificate, pneumonia, and nasogastric tube use increased medical expenses and length of hospital stay. Conclusions: Improving COC reduces medical costs and the number of inpatient days in children with CP. Certain characteristics also influence these outcomes.

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“…To date, literature has explored effective and efficient features of transition practices and programmes 37-40 , explored the perspectives of healthcare professionals 25,26 and experiences of young people and their families 34,41-44 and the impact of transitional care on measurable outcomes [45][46][47] . A number of scoping reviews have explored transition among CYP with physical 48 , mental health 49,50 and endocrine, neurological and gastrointestinal conditions 51,52 .…”

Section: Introductionmentioning

confidence: 99%

Transition from child-centred to adult-oriented healthcare systems for young people with neurodisability: a scoping review protocol

et al. 2020

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Background: The transition from child-centred to adult-oriented healthcare is a challenging time for young people with neurodisability. As the prevalence of neurodisability increases, greater numbers of young people will eventually transfer to the adult healthcare system. While there is a growing recognition of the importance of providing quality, transitional care, little is known about how to manage and optimise this process for young people with neurodisability. The objective of this scoping review is to examine and map existing literature related to the transition from child-centred to adult-oriented healthcare systems for young people with neurodisability. Methods: Systematic literature searches of OVID MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library and Web of Science will be conducted from inception to present. A structured iterative search of grey literature will be conducted. This review will consider all study designs examining the transition from child to adult health services in neurodisability. Two reviewers will independently screen each retrieved title and abstract and assess full-text articles against the inclusion criteria to determine eligibility. Data will be extracted and synthesised quantitatively and qualitatively. The process and reporting will follow PRISMA-ScR guidelines. Conclusion: This review will provide a broad and systematically mapped synthesis of the extent and nature of the available published and unpublished literature on transition from child-centred to adult-oriented healthcare systems in neurodisability. The results will be used to determine gaps in the current evidence base in order to prioritise areas for future research.

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The Effect of a Comprehensive Care Transition Model on Cost and Utilization for Medically Complex Children With Cerebral Palsy

Cited by 19 publications

References 21 publications

A Novel Model for Enhanced Prediction and Understanding of Unplanned 30-Day Pediatric Readmission

A Novel Model for Enhanced Prediction and Understanding of Unplanned 30-Day Pediatric Readmission

Continuity of Care Is Associated with Medical Costs and Inpatient Days in Children with Cerebral Palsy

Transition from child-centred to adult-oriented healthcare systems for young people with neurodisability: a scoping review protocol

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