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01-09-2019 | Care | Review Paper

Key Population Health Outcomes for Children with Medical Complexity: A Systematic Review

Authors: Elizabeth S. Barnert, Ryan J. Coller, Bergen B. Nelson, Lindsey R. Thompson, John Tran, Vincent Chan, Cesar Padilla, Thomas S. Klitzner, Moira Szilagyi, Paul J. Chung

Published in: Maternal and Child Health Journal | Issue 9/2019

Abstract

Introduction

Despite the significant healthcare policy and program implications, a summary measure of health for children with medical complexity (CMC) has not been identified. It is unclear whether existing population health approaches apply to CMC. We conducted a systematic review of the existing peer-reviewed research literature on CMC to describe the health outcomes currently measured for CMC.

Methods

We searched MEDLINE and PsycINFO by linking combinations of key words from three groups of concepts: (1) pediatric, (2) medical complexity, and (3) chronicity or severity. Study eligibility criteria were research studies including CMC with any outcome reported. Data on the outcomes were systematically extracted. Iterative content analysis organized outcomes into conceptual domains and sub-domains.

Results

Our search yielded 3853 articles. After exclusion criteria were applied, 517 articles remained for data extraction. Five distinct outcome domains and twenty-four sub-domains emerged. Specifically, 50% of the articles studied healthcare access and use; 43% family well-being; 39% child health and well-being; 38% healthcare quality; and 25% adaptive functioning. Notably lacking were articles examining routine child health promotion as well as child mental health and outcomes related to family functioning.

Conclusions

Key health domains for CMC exist. Adaptations of existing sets of metrics and additional tools are needed to fully represent and measure population health for CMC. This approach may guide policies and programs to improve care for CMC.

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Title: Key Population Health Outcomes for Children with Medical Complexity: A Systematic Review
Authors: Elizabeth S. Barnert
Ryan J. Coller
Bergen B. Nelson
Lindsey R. Thompson
John Tran
Vincent Chan
Cesar Padilla
Thomas S. Klitzner
Moira Szilagyi
Paul J. Chung
Publication date: 01-09-2019
Publisher: Springer US
Keyword: Care
Published in: Maternal and Child Health Journal / Issue 9/2019
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-019-02752-1

At a glance: The STEP trials

Springer Medicine

Key Population Health Outcomes for Children with Medical Complexity: A Systematic Review

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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