Patterns and costs of health care use of children with medical complexity

Pediatrics

Volumn 130, Issue 6, 2012, Pages

  Cohen, Eyal ^a,b   Berry, Jay G ^c   Camacho, Ximena ^d   Anderson, Geoff ^b,d   Wodchis, Walter ^b,d,e   Guttmann, Astrid ^a,b,d  

^a HOSPITAL FOR SICK CHILDREN   (Canada)

^b UNIVERSITY OF TORONTO   (Canada)

^c INSTITUTE FOR CLINICAL EVALUATIVE SCIENCES   (Canada)

^d BOSTON CHILDREN S HOSPITAL   (United States)

^e TORONTO REHABILITATION INSTITUTE   (Canada)

Author keywords

Children; Complex chronic conditions; Health care utilization; Technology assistance

Indexed keywords

ADOLESCENT; ARTICLE; ASSISTIVE TECHNOLOGY DEVICE; CANADA; CHILD; CHILDHOOD DISEASE; CHRONIC DISEASE; COHORT ANALYSIS; COMPLEX CHRONIC DISEASE; FEMALE; HANDICAPPED CHILD; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH CARE UTILIZATION; HOME CARE; HOSPITAL DISCHARGE; HOSPITAL READMISSION; HUMAN; INFANT; MAJOR CLINICAL STUDY; MALE; MEDICAL SPECIALIST; MULTIPLE ORGAN FAILURE; NEUROLOGIC DISEASE; NEWBORN; PATIENT CARE; PHYSICIAN; POPULATION RESEARCH; PRESCHOOL CHILD; PRIORITY JOURNAL; RETROSPECTIVE STUDY; SCHOOL CHILD;

EID: 84870554607     PISSN: 00314005     EISSN: 10984275     Source Type: Journal    
DOI: 10.1542/peds.2012-0175     Document Type: Article

References (49)

1. Gawande A. The hot spotters: can we lower medical costs by giving the neediest patients better care? New Yorker. 2011 (January 24);40-51
2. Zook CJ, Moore FD. High-cost users of medical care. N Engl J Med. 1980;302(18):996-1002
3. van Walraven C, Dhalla IA, Bell C, et al. Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. CMAJ. 2010;182(6):551-557
4. Berry JG, Agrawal R, Kuo DZ, et al. Characteristics of hospitalizations for patients who use a structured clinical care program for children with medical complexity. J Pediatr. 2011;159(2):284-290
5. Simon TD, Berry J, Feudtner C, et al. Children with complex chronic conditions in inpatient hospital settings in the United States. Pediatrics. 2010;126(4):647-655
6. Burns KH, Casey PH, Lyle RE, Bird TM, Fussell JJ, Robbins JM. Increasing prevalence of medically complex children in US hospitals. Pediatrics. 2010;126(4):638-646
7. Berry JG, Hall DE, Kuo DZ, et al. Hospital utilization and characteristics of patients experiencing recurrent readmissions within children's hospitals. JAMA. 2011;305(7):682-690
8. OHIP eligibility. Available at: www.health. gov.on.ca/english/public/pub/ ohip/eligibility.html. Accessed March 11, 2012
9. Srivastava R, Berry JG, Hall M, et al. Reflux related hospital admissions after fundoplication in children with neurological impairment: retrospective cohort study. BMJ. 2009;339:b4411
10. Srivastava R, Downey EC, Feola P, et al. Quality of life of children with neurological impairment who receive a fundoplication for gastroesophageal reflux disease. J Hosp Med. 2007;2(3):165-173 (Pubitemid 47034231)
11. Feudtner C, Christakis DA, Connell FA. Pediatric deaths attributable to complex chronic conditions: a population-based study of Washington State, 1980-1997. Pediatrics. 2000;106(1 pt 2):205-209 (Pubitemid 30436857)
12. Feudtner C, Silveira MJ, Christakis DA. Where do children with complex chronic conditions die? Patterns in Washington State, 1980-1998. Pediatrics. 2002;109(4):656-660 (Pubitemid 34286300)
13. Pink GH, Bolley HB. Physicians in health care management: 3. Case Mix Groups and Resource Intensity Weights: an overview for physicians. CMAJ. 1994;150(6):889-894 (Pubitemid 24144099)
14. Campbell L. CIHI case mix tools. In: Johnson L, Richards J, Pink G, Campbell L, eds. Case Mix Tools for Decision Making in Health Care. Ottawa, ON: Canadian Institute for Health Information; 1998:1-10
15. Pink GH, Bolley HB. Physicians in health care management: 4. Case Mix Groups and Resource Intensity Weights: physicians and hospital funding. CMAJ. 1994;150(8):1255-1261 (Pubitemid 24168475)
16. Canadian Institute for Health Information. Acute care grouping methodologies: from diagnosis related groups to case mix groups redevelopment. 2004. Available at: http://secure.cihi.ca/cihiweb/products/Acute-Care-Grouping- Methodologies2004-e.pdf. Accessed March 23, 2012
17. Canadian Institute for Health Information. Comprehensive Ambulatory Classification System (CACS). Available at: www.cihi.ca/CIHI-ext-portal/ internet/en/document/standards+and+data+submission/standards/case+mix/ casemix-cacs. Accessed March 23, 2012
18. Ontario Ministry of Health and Long-Term Care Financial Information Management Branch Web site. Available at: www. mohltcfim.com. Accessed October 5, 2012
19. Wodchis WP, Bushmeneva K, Nikitovic M, McKillop I. Guidelines on Person Centered Costing Using Administrative Databases in Ontario. Toronto, Canada: Health System Performance Research Network; 2012
20. Buescher PA, Whitmire JT, Brunssen S, Kluttz-Hile CE. Children who are medically fragile in North Carolina: using Medicaid data to estimate prevalence and medical care costs in 2004. Matern Child Health J. 2006;10(5):461-466 (Pubitemid 44445976)
21. Neff JM, Sharp VL, Muldoon J, Graham J, Myers K. Profile of medical charges for children by health status group and severity level in a Washington State Health Plan. Health Serv Res. 2004;39(1):73-89 (Pubitemid 38124792)
22. Neff JM, Sharp VL, Muldoon J, Graham J, Popalisky J, Gay JC. Identifying and classifying children with chronic conditions using administrative data with the clinical risk group classification system. Ambul Pediatr. 2002;2(1):71-79 (Pubitemid 44133345)
23. Neff JM, Sharp VL, Popalisky J, Fitzgibbon T. Using medical billing data to evaluate chronically ill children over time. J Ambul Care Manage. 2006;29(4):283-290 (Pubitemid 44427343)
24. Wilkins R. Trends in ages at death where congenital anomaly was the underlying cause. Canadian Congenital Anomalies Surveillance Network (CCASN), 6th Scientific Meeting; November 20, 2007; Ottawa, Canada
25. Tennant PW, Pearce MS, Bythell M, Rankin J. 20-year survival of children born with congenital anomalies: a population-based study. Lancet. 2010;375(9715):649-656
26. Wong LY, Paulozzi LJ. Survival of infants with spina bifida: a population study, 1979-94. Paediatr Perinat Epidemiol. 2001;15(4):374-378
27. Plioplys AV, Kasnicka I, Lewis S, Moller D. Survival rates among children with severe neurologic disabilities. South Med J. 1998;91(2):161-172 (Pubitemid 28340297)
28. Plioplys AV. Survival rates of children with severe neurologic disabilities: a review. Semin Pediatr Neurol. 2003;10(2):120-129 (Pubitemid 37222279)
29. Mathews TJ, Honein MA, Erickson JD. Spina bifida and anencephaly prevalence - United States, 1991-2001. MMWR Recomm Rep. 2002;51(RR-13):9-11
30. Canadian Perinatal Health Report, 2008 Edition. Ottawa, Canada: Public Health Agency of Canada, 2008
31. Wilson-Costello D, Friedman H, Minich N, Fanaroff AA, Hack M. Improved survival rates with increased neurodevelopmental disability for extremely low birth weight infants in the 1990s. Pediatrics. 2005;115(4):997-1003
32. Kobaly K, Schluchter M, Minich N, et al. Outcomes of extremely low birth weight (<1 kg) and extremely low gestational age (<28 weeks) infants with bronchopulmonary dysplasia: effects of practice changes in 2000 to 2003. Pediatrics. 2008;121(1):73-81
33. Wilson-Costello D. Is there evidence that long-term outcomes have improved with intensive care? Semin Fetal Neonatal Med. 2007;12(5):344-354 (Pubitemid 47386048)
34. Vincer MJ, Allen AC, Joseph KS, Stinson DA, Scott H, Wood E. Increasing prevalence of cerebral palsy among very preterm infants: a population-based study. Pediatrics. 2006;118(6). Available at: www.pediatrics.org/cgi/content/ full/118/6/e1621
35. Kuo DZ, Cohen E, Agrawal R, Berry JG, Casey PH. A national profile of caregiver challenges among more medically complex children with special health care needs. Arch Pediatr Adolesc Med. 2011;165(11):1020-1026
36. Brehaut JC, Kohen DE, Raina P, et al. The health of primary caregivers of children with cerebral palsy: how does it compare with that of other Canadian caregivers? Pediatrics. 2004;114(2). Available at: www.pediatrics.org/cgi/ content/full/114/2/e182
37. Nageswaran S, Silver EJ, Stein REK. Association of functional limitation with health care needs and experiences of children with special health care needs. Pediatrics. 2008;121(5):994-1001
38. Cohen E, Kuo DZ, Agrawal R, et al. Children with medical complexity: an emerging population for clinical and research initiatives. Pediatrics. 2011;127(3):529-538
39. Gordon JB, Colby HH, Bartelt T, Jablonski D, Krauthoefer ML, Havens P. A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs. Arch Pediatr Adolesc Med. 2007;161(10):937-944 (Pubitemid 47529410)
40. Casey PH, Lyle RE, Bird TM, et al. Effect of hospital-based comprehensive care clinic on health costs for Medicaid-insured medically complex children. Arch Pediatr Adolesc Med. 2011;165(5):392-398
41. Cohen E, Friedman JN, Mahant S, Adams S, Jovcevska V, Rosenbaum P. The impact of a complex care clinic in a children's hospital. Child Care Health Dev. 2010;36(4):574-582
42. Broyles RS, Tyson JE, Heyne ET, et al. Comprehensive follow-up care and life-threatening illnesses among high-risk infants: a randomized controlled trial. JAMA. 2000;284(16):2070-2076
43. Miller AR, Condin CJ, McKellin WH, Shaw N, Klassen AF, Sheps S. Continuity of care for children with complex chronic health conditions: parents'perspectives. BMC Health Serv Res. 2009;9:242
44. Lach LM, Kohen DE, Garner RE, et al. The health and psychosocial functioning of caregivers of children with neurodevelopmental disorders. Disabil Rehabil. 2009;31(8):607-618
45. Ratliffe CE, Harrigan RC, Haley J, Tse A, Olson T. Stress in families with medically fragile children. Issues Compr Pediatr Nurs. 2002;25(3):167-188
46. Sabbeth BF, Leventhal JM. Marital adjustment to chronic childhood illness: a critique of the literature. Pediatrics. 1984;73(6):762-768 (Pubitemid 14111774)
47. Palfrey JS, Sofis LA, Davidson EJ, Liu J, Freeman L, Ganz ML; Pediatric Alliance for Coordinated Care. The Pediatric Alliance for Coordinated Care: evaluation of a medical home model. Pediatrics. 2004;113(suppl 5):1507-1516 (Pubitemid 38584576)
48. Cohen E, Jovcevska V, Kuo DZ, Mahant S. Hospital-based comprehensive care programs for children with special health care needs: a systematic review. Arch Pediatr Adolesc Med. 2011;165(6):554-561
49. Burke RT, Alverson B. Impact of children with medically complex conditions. Pediatrics. 2010;126(4):789-790