The Goldilocks problem: Healthcare delivery models for children with medical complexity.

Autor: Galligan MM; Department of Pediatrics, Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Philadelphia, PA 19104, United States; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Leonard Davis Institute for Healthcare Economics, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: galliganm@chop.edu., Hogan AK; Department of Pediatrics, Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Philadelphia, PA 19104, United States.
Jazyk: angličtina
Zdroj: Current problems in pediatric and adolescent health care [Curr Probl Pediatr Adolesc Health Care] 2021 Dec; Vol. 51 (12), pp. 101127. Date of Electronic Publication: 2022 Jan 06.
DOI: 10.1016/j.cppeds.2021.101127
Abstrakt: Health systems have increasingly adapted elements of the medical home model in designing complex care programs for children with medical complexity (CMC). In recent years, several key complex care program designs have emerged. These programs have been shown to be effective in improving the quality and cost of care for CMC. In designing and implementing a complex care model, there are many variables a health system must consider to ensure program viability. To address CMC across the continuum of care, tertiary care systems should implement a portfolio of complex care models to accommodate the population's diverse needs. Further study is needed to establish 'gold standards' for complex care delivery models, but a major factor affecting program innovation is reimbursement, as the fee for service model does not adequately support the enhanced services required to ensure high value, high quality care for CMC. It is thus critical that stakeholders from health systems and payers align to engage in innovation in complex care delivery design and implementation. Without this partnership, advances in care delivery for CMC will be limited.
Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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