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01.12.2017 | Research | Ausgabe 1/2017 Open Access

Italian Journal of Pediatrics 1/2017

Care coordination for children with special health care needs: a cohort study

Zeitschrift:
Italian Journal of Pediatrics > Ausgabe 1/2017
Autoren:
Elisa Zanello, Simona Calugi, Lee M. Sanders, Jacopo Lenzi, Giacomo Faldella, Paola Rucci, Maria Pia Fantini
Wichtige Hinweise

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.

Abstract

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.
Zusatzmaterial
Additional file 1: The SpeNK-FP instrument in its original form (Italian language). “Scheda per l’attività di coordinamento del PLS”. (PDF 590 kb)
13052_2017_342_MOESM1_ESM.pdf
Additional file 2: The dataset of the encounters and the codebook. “SpeNK-FP records about activity performed by FPs”. (XLS 255 kb)
13052_2017_342_MOESM2_ESM.xls
Literatur
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