Care coordination for children with special health care needs: a cohort study
| Autor: | Jacopo Lenzi, Elisa Zanello, Paola Rucci, Giacomo Faldella, Lee M. Sanders, Maria Pia Fantini, Simona Calugi |
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| Přispěvatelé: | Zanello, Elisa, Calugi, Simona, Sanders, Lee M., Lenzi, Jacopo, Faldella, Giacomo, Rucci, Paola, Fantini, Maria Pia |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Child Health Services Special needs Assessment Social issues Pediatrics Cohort Studies 03 medical and health sciences 0302 clinical medicine Ambulatory care Respite care 030225 pediatrics Care coordination Surveys and Questionnaires Health care Children with special healthcare need medicine Humans 030212 general & internal medicine Prospective Studies Pediatric primary care Child Physician's Role Unlicensed assistive personnel Children with special healthcare needs Patient Care Team business.industry Research Infant Newborn Family pediatrician Disabled Children Integrated care Italy Family medicine Child Preschool Pediatrics Perinatology and Child Health Female business Needs Assessment Cohort study Follow-Up Studies |
| Zdroj: | Italian Journal of Pediatrics |
| ISSN: | 1824-7288 |
| Popis: | Background Care coordination is widely recognized as a key element of care for patients with chronic and complex medical conditions and their families. In care for children with special health care needs the Family Pediatrician (FP) plays a central role as care coordinator. This study aims to evaluate the FPs’ activities of care coordination for children with special health care needs in the pediatric primary care setting, using an on-line measurement tool. Methods Within the prospective cohort study SpeNK (Special Needs Kids), newborns and children with special health care needs were recruited at discharge from three hospital facilities in Bologna province, from October 1st 2012 to September 30th 2014. Their FPs were invited to complete a questionnaire (SpeNK-FP) at each encounter for the patient during a 9-month period after hospital discharge. SpeNK-FP was developed by adapting the Care Coordination Measurement Tool (CCMT©) developed by Antonelli et al., to the Italian organizational context. The outcome of interest, derived from the questionnaire, is inappropriate use of services. Results Forty FPs completed assessments for 49 children at each of 382 clinical encounters. The majority of children (71.4%) had special health care needs, without complicating social issues. FPs reported “no need for care coordination” in 50.8% of the encounters and 41.1% of records about patient needs requiring care coordination. The most common activity implemented to meet children’s needs was telephone contact with a medical provider. According to FPs, 80% of encounters prevented inappropriate services use. In multivariate regression, pediatric-specialist contact (telephone or in person) was associated with reduced odds of physician report of preventable hospitalization (OR = 0.06, 95% CI 0.01–0.42, p = 0.005). Conclusions The study shows the potential for FPs in Italy to serve as care coordinators and facilitate the implementation of integrated care pathways for children with special health care needs. Electronic supplementary material The online version of this article (doi:10.1186/s13052-017-0342-3) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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