Interpreting Variability in the Health Care Utilization of Children With Medical Complexity

PEDIATRICS ◽  
2015 ◽  
Vol 136 (5) ◽  
pp. 974-976
Author(s):  
J. Thomson ◽  
S. S. Shah
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Children With Medical Complexity ◽  
Medical Complexity

Hospital Variation in Health Care Utilization by Children With Medical Complexity

PEDIATRICS ◽  
2015 ◽  
Vol 136 (5) ◽  
pp. 860-867 ◽  
Author(s):  
S. L. Ralston ◽  
W. Harrison ◽  
J. Wasserman ◽  
D. C. Goodman
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Children With Medical Complexity ◽  
Hospital Variation ◽  
Medical Complexity

Health care utilization and spending among privately insured children with medical complexity

2018 ◽  
Vol 23 (2) ◽  
pp. 213-231 ◽  
Author(s):  
Angela Wangari Walter ◽  
Randall P Ellis ◽  
Yiyang Yuan
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Service Utilization ◽  
Health Plan ◽  
Care Utilization ◽  
Children With Medical Complexity ◽  
Health Maintenance ◽  
Medical Complexity ◽  
Financial Burdens ◽  
Families With Children

Children with medical complexity have high health service utilization and health expenditures that can impose significant financial burdens. This study examined these issues for families with children enrolled in US private health plans. Using IBM Watson/Truven Analytics℠ MarketScan® commercial claims and encounters data (2012–2014), we analyzed through regression models, the differences in health care utilization and spending of disaggregated health care services by health plan types and children’s medical complexity levels. Children in consumer-driven and high-deductible plans had much higher out-of-pocket spending and cost shares than those in health maintenance organizations and preferred provider organizations (PPOs). Children with complex chronic conditions had higher service utilization and out-of-pocket expenditures while having lower cost shares on various categories of services than those without any chronic condition. Compared to families covered by PPOs, those with high-deductible or consumer-driven plans were 2.7 and 1.7 times more likely to spend over US$1000 out of pocket on their children’s medical care, respectively. Families with higher complexity levels were more likely to experience financial burdens from expenditures on children’s medical services. In conclusion, policymakers and families with children need to be cognizant of the significant financial burdens that can arise from children’s complex medical needs and health plan demand-side cost sharing.

scholarly journals Variation in Child Health Care Utilization by Medical Complexity

2014 ◽  
Vol 19 (1) ◽  
pp. 40-48 ◽  
Author(s):  
Dennis Z. Kuo ◽  
Maria Melguizo-Castro ◽  
Anthony Goudie ◽  
Todd G. Nick ◽  
James M. Robbins ◽  
...  
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Child Health Care ◽  
Medical Complexity

Emergency Care of Children with Medical Complexity

2020 ◽  
pp. 603-610
Author(s):  
Christian D. Pulcini ◽  
Annique Hogan ◽  
Eron Friedlaender
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Emergency Care ◽  
Pediatric Population ◽  
Tertiary Care ◽  
Care Utilization ◽  
Care Needs ◽  
Children With Medical Complexity ◽  
Number Of Children ◽  
Medical Complexity

Advancements in pediatric care have led to a significant increase in the number of children living longer (or living into adulthood) with medical complexity. Children with medical complexity are generally defined as those with multiple significant chronic health problems involving multiple organ systems, which result in functional limitations, high health care needs or utilization, and often require need for, or use of, medical technology. Although children with medical complexity represent less than 1% of the pediatric population, they account for a large proportion of health care utilization among children, including acute care and emergency department settings. Many of these children receive a majority of their specialty and outpatient care at tertiary care children’s hospitals, but evidence indicates that 80–90% of encounters for emergency care are at community emergency departments. Furthermore, many of the complex, chronic conditions that characterize children with medical complexity are becoming more clinically relevant to all providers as this subgroup of children mature into adulthood. Therefore, it has and will become increasingly relevant for all emergency providers to be prepared to evaluate and manage what have been traditionally pediatric conditions, technologies, and complications among children in this population. This chapter uses a case-based approach to illustrate more common and challenging patient scenarios when evaluating and treating children with medical complexity in the emergency department.

scholarly journals Medication safety for children with medical complexity

2020 ◽  
Vol 25 (7) ◽  
pp. 473-473
Author(s):  
Kathleen Huth ◽  
Patricia Vandecruys ◽  
Julia Orkin ◽  
Hema Patel
Keyword(s):  
Health Care ◽  
Medication Errors ◽  
Health Care Professionals ◽  
Chronic Conditions ◽  
Medication Safety ◽  
Care Utilization ◽  
Children With Medical Complexity ◽  
Technology Dependence ◽  
Medical Complexity ◽  
Care Fragmentation

Abstract Due to advances in medical care and innovations in health technology, many children with life-limiting conditions are now living longer. These children are often referred to as ‘children with medical complexity (CMC)’, and they are characterized by chronic conditions, increased health care utilization, and technology dependence. Their complexity of care and inherent fragility lead to higher risk for medication errors, both in-community and in-hospital. High rates of care fragmentation, miscommunication, and polypharmacy in CMC increase opportunities for error, particularly as children transition between health care settings and practitioners. Data on the factors contributing to higher risk of medication errors in this population and how they can be effectively addressed are lacking. This practice point provides clinical guidance for health care professionals to ensure medication safety when caring for CMC, with focus on practical strategies for outpatient and inpatient care.

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