The Need for Care Coordination Among Children with Special Health Care Needs in Illinois

Rosenberg, Deborah; Onufer, Charles N.; Clark, Gerri; Wilkin, Thomas; Rankin, Kristin; Gupta, Kristina

doi:10.1007/s10995-005-3857-y

Cited by 11 publications

(6 citation statements)

References 8 publications

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“…Given that the median time from initial screen to confirmatory diagnosis was over 3 months in all groups, an initial screening that occurs after 1 month of age will make it extremely difficult for families to obtain a diagnosis by 3 months of age. These findings are consistent with reports of delayed care among children and youth with special health care needs (Bitsko et al, 2009; Dusing, Skinner, & Mayer, 2004; Rosenberg et al, 2005; Tippy et al, 2005; Viner-Brown & Kim, 2005). …”

Section: Discussionsupporting

confidence: 91%

“…Some evidence suggests that the presence of comorbid conditions may affect both the timing and overall rate of screening, diagnosis, and intervention for HL. Studies of children and youth with special health care needs have shown that children with more than one condition (Bitsko et al, 2009), and more severe conditions (Rosenberg et al, 2005; Tippy, Meyer, Aronson, & Wall, 2005), had an increased risk for having unmet needs, including obtaining hearing aids or other devices. In a 3-year cohort study of 39,000 infants born in Rhode Island, Vohr, Moore, and Tucker (2002) found that infants in the neonatal intensive care unit (NICU) were 16.4 times more likely to miss the initial hearing screening and nearly six times more likely to miss their rescreen compared with infants in the well-baby nursery.…”

mentioning

confidence: 99%

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Impact of Co-Occurring Birth Defects on the Timing of Newborn Hearing Screening and Diagnosis

et al. 2011

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Purpose Early detection of hearing loss in all newborns and timely intervention are critical to children's cognitive, verbal, behavioral, and social development. The initiation of appropriate early intervention services before 6 months of age can prevent or reduce negative developmental consequences. The purpose of this study was to assess, using large, population-based registries, the effect of co-occurring birth defects (CBDs) on the timing and overall rate of hearing screening and diagnosis. Method The authors linked statewide data from newborn hearing screenings, a birth defects registry, and birth certificates to assess the timeliness of newborn hearing screening and diagnosis of hearing loss (HL) for infants with and without CBDs in 485 children with confirmed HL. Results Nearly one third (31.5%) of children with HL had 1 or more CBDs. The presence of CBDs prolonged the time of the initial infant hearing screening, which contributed to further delays in the subsequent diagnosis of HL. Conclusions Better coordination of HL assessment into treatment plans for children with CBDs may enable earlier diagnosis of HL and provide opportunities for intervention that will affect long-term developmental outcomes for these children.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Impact of Co-Occurring Birth Defects on the Timing of Newborn Hearing Screening and Diagnosis

et al. 2011

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“…23 An Illinois study showed that children, youth, and their families had a higher need for care coordination when communication between health care providers was inadequate. 24 Care coordination within primary care pediatric practices is associated with decreased unnecessary office and emergency department (ED) visits, enhanced family satisfaction, and reduced unplanned hospitalizations and ED visits. [25][26][27] According to research in New Orleans, families of children and youth with special health care needs in an underserved population experienced enhanced services from nurse care coordinator support.…”

Section: Benefits Of and Evidence For Care Coordinationmentioning

confidence: 99%

Patient- and Family-Centered Care Coordination: A Framework for Integrating Care for Children and Youth Across Multiple Systems

Turchi¹,

Antonelli²,

Norwood³

et al. 2014

Pediatrics

263

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Understanding a care coordination framework, its functions, and its effects on children and families is critical for patients and families themselves, as well as for pediatricians, pediatric medical subspecialists/ surgical specialists, and anyone providing services to children and families. Care coordination is an essential element of a transformed American health care delivery system that emphasizes optimal quality and cost outcomes, addresses family-centered care, and calls for partnership across various settings and communities. High-quality, cost-effective health care requires that the delivery system include elements for the provision of services supporting the coordination of care across settings and professionals. This requirement of supporting coordination of care is generally true for health systems providing care for all children and youth but especially for those with special health care needs. At the foundation of an efficient and effective system of care delivery is the patient-/family-centered medical home. From its inception, the medical home has had care coordination as a core element. In general, optimal outcomes for children and youth, especially those with special health care needs, require interfacing among multiple care systems and individuals, including the following: medical, social, and behavioral professionals; the educational system; payers; medical equipment providers; home care agencies; advocacy groups; needed supportive therapies/services; and families. Coordination of care across settings permits an integration of services that is centered on the comprehensive needs of the patient and family, leading to decreased health care costs, reduction in fragmented care, and improvement in the patient/family experience of care. Pediatrics 2014;133:e1451-e1460

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“…Consequently, children with special health care needs likely receive less than best possible care. Poor, uninsured and minority children may be at a heightened risk for inferior coordination of services [17,18]. …”

Section: Barrier 3: Compromised Quality Of Care Due To Current Healthmentioning

confidence: 99%

Policy challenges for the pediatric rheumatology workforce: Part I. Education and economics

Henrickson

2011

Pediatr Rheumatol

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For children with rheumatic conditions, the available pediatric rheumatology workforce mitigates their access to care. While the subspecialty experiences steady growth, a critical workforce shortage constrains access. This three-part review proposes both national and international interim policy solutions for the multiple causes of the existing unacceptable shortfall. Part I explores the impact of current educational deficits and economic obstacles which constrain appropriate access to care. Proposed policy solutions follow each identified barrier.Challenges consequent to obsolete, limited or unavailable exposure to pediatric rheumatology include: absent or inadequate recognition or awareness of rheumatic disease; referral patterns that commonly foster delays in timely diagnosis; and primary care providers' inappropriate or outdated perception of outcomes. Varying models of pediatric rheumatology care delivery consequent to market competition, inadequate reimbursement and uneven institutional support serve as additional barriers to care.A large proportion of pediatrics residency programs offer pediatric rheumatology rotations. However, a minority of pediatrics residents participate. The current generalist pediatrician workforce has relatively poor musculoskeletal physical examination skills, lacking basic competency in musculoskeletal medicine. To compensate, many primary care providers rely on blood tests, generating referrals that divert scarce resources away from patients who merit accelerated access to care for rheumatic disease. Pediatric rheumatology exposure could be enhanced during residency by providing a mandatory musculoskeletal medicine rotation that includes related musculoskeletal subspecialties. An important step is the progressive improvement of many providers' fixed referral and laboratory testing patterns in lieu of sound physical examination skills.Changing demographics and persistent reimbursement disparities will require workplace innovation and legislative reform. Reimbursement reform is utterly essential to extending patient access to subspecialty care. In practice settings characterized by a proportion of Medicaid-subsidized patients in excess of the national average (> 41%), institutional support is vital. Accelerating access to care will require the most efficient deployment of existing, limited resources. Practice redesign of such resources can also improve access, e.g., group appointments and an escalating role for physician extenders. Multidisciplinary, team-oriented care and telemedicine have growing evidence basis as solutions to limited access to pediatric rheumatology services.

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The Need for Care Coordination Among Children with Special Health Care Needs in Illinois

Cited by 11 publications

References 8 publications

Impact of Co-Occurring Birth Defects on the Timing of Newborn Hearing Screening and Diagnosis

Impact of Co-Occurring Birth Defects on the Timing of Newborn Hearing Screening and Diagnosis

Patient- and Family-Centered Care Coordination: A Framework for Integrating Care for Children and Youth Across Multiple Systems

Policy challenges for the pediatric rheumatology workforce: Part I. Education and economics

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