Payment for Obesity Services: Examples and Recommendations for Stage 3 Comprehensive Multidisciplinary Intervention Programs for Children and Adolescents
| Autor: | Daniel A. DeUgarte, Lenna L. Liu, Karan Staten, Wendy Slusser, Matthew Haemer, Karen Stephens, Christine Yeh, Sarah C. Armstrong |
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| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Adolescent media_common.quotation_subject Child Health Services Specialty Supplement Articles Health Promotion Childhood obesity Cost of Illness Nursing Multidisciplinary approach Outcome Assessment Health Care Health care Humans Medicine Obesity Child Reimbursement media_common Patient Care Team Chronic care business.industry Disease Management Hospitals Pediatric medicine.disease Payment Mental health United States Models Organizational Family medicine Insurance Health Reimbursement Pediatrics Perinatology and Child Health business |
| Zdroj: | Pediatrics |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2011-0480h |
| Popis: | OBJECTIVE: The Reimbursement and Payment Subcommittee of the National Association of Children's Hospitals and Related Institutions FOCUS on a Fitter Future group sought to guide medical providers, patients, and payers to better serve obese children and adolescents to enable optimum health. Recommendations are provided for the essential components of a stage 3 comprehensive multidisciplinary intervention program as defined by the 2007 Expert Committee recommendations. In addition, suggestions are offered for a stepwise approach to implement these recommendations. METHODS: In 2009, key informant interviews were conducted with 15 children's hospitals participating in FOCUS on a Fitter Future and 1 nonparticipating hospital. Interview transcripts identified 5 financially sustainable stage 3 programs, each funded differently. RESULTS: The stage 3 programs interviewed ranged from being nascent to 21 years old (27%, 6 years). All of them had multidisciplinary teams that delivered services through 1 of 3 institutional structures: 60% freestanding; 7% specialty; and 33% hospital within a hospital. One-third of them had 1 to 2 funding sources, and 67% had ≥3 sources. CONCLUSIONS: The stage 3 programs in this review shared some common strategies for achieving financial stability. All of them followed key strategies of the chronic care model, the details of which led to the following recommendation: stage 3 programs should include a health care team with a medical provider, registered dietitian, physical activity specialist, mental health specialist, and coordinator who, as a team, provide service to overweight and obese children at no less than moderate intensity (26–75 hours). |
| Databáze: | OpenAIRE |
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