Understanding the impact of special health care needs on early school functioning: a conceptual model

AbstractObjectiveThe purpose of this study was to describe disaster preparedness strategies and behaviors among rural families who have children with special health care needs and to examine the effect of self-efficacy and response-efficacy on disaster preparedness.MethodsData for this study were drawn from the baseline surveys of 287 rural families with children with special health care needs who were part of a randomized controlled trial examining the impact of an intervention on disaster preparedness. Distributions of child, parent, and family characteristics were examined by preparedness. Linear regression models were built to examine the impact of self-efficacy and response-efficacy on level of disaster preparedness.ResultsDisaster preparedness (overall, emergency plan, discussion/practice, and supplies) was low (40.9-69.7%) among study families. Disaster preparedness was found to increase with each unit increase in the level of self-efficacy and family resilience sources across all 4 categories of preparedness.ConclusionsDisaster preparedness among rural families with children with special health care needs is low, which is concerning because these children may have increased vulnerability to adverse outcomes compared to the general population. Results suggest that increasing the levels of self-efficacy and family resilience sources may increase disaster preparedness. (Disaster Med Public Health Preparedness. 2016;10:225–232)

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Home hospitalization in children and youth with special health care needs (cyshcn): financial perspectives in hospital de alta complexidad, Chile

Revista de la Facultad de Medicina Humana ◽

10.25176/rfmh.v21i4.4267 ◽

2021 ◽

Vol 21 (4) ◽

pp. 700-709

Author(s):

Francisco Prado Atlagic ◽

Carlos Valdebenito Parra ◽

Niscka Babaic Müller ◽

Pamela Salinas Flores ◽

Fernando Muñoz Berríos ◽

...

Keyword(s):

Health Care ◽

Special Health Care Needs ◽

Children And Youth ◽

Health Care Needs ◽

High Complexity ◽

Care Needs ◽

Special Health Care ◽

Hospital Production ◽

The Impact ◽

Special Health

Introduction. The absence of home hospitalization (HH) of children and youth with special health care needs (CYSHCN) generates prolonged hospitalizations in closed care (CC). Objective: To compare the estimated cost of HH of high complexity CYSHCN versus the actual cost of the same patient in CC and its impact on hospital production. Methods: Descriptive and comparative study between costs of both hospitalization modalities of high complexity CYSHCN. From January to December 2016, non-oncological CYSHCN hospitalizations were registered by the Pediatric Service (PS) according to the Ministry of Health-Chile (MINSAL) norm. It was classified for clinical groups and similar consumption of resources according to groups related to diagnosis (DRG). The stay was adjusted, and financial analysis of both modalities (CC) and (HH) was performed to evaluate the impact on hospital production. Results: Of 3690 discharges, 126 (3.4%) were related to 27 CYSHCN, the average age was 4.6 years (± 5 SD) with technological dependencies to live. The mean CYSHCN stay was 16 days, compared with 5.9 for patients without special health needs. CYSHCN stays reached 2017 days (8.6%). Disregarding the CYSHCN discharges would have contributed 320 additional discharges, and his HH would have saved US $ 15 / day per patient, which for the total number of stays consumed would have been an annual saving of US $ 29170. Conclusion: HH has an estimated cost lower than the CA of high complexity CYSHCN, improves hospital productivity, and frees critical beds with financially viable investment.

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