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Review
. 2013 Dec;18(10):518-22.
doi: 10.1093/pch/18.10.518.

Children with medical complexity in Canada

Tammie Dewan  1 , Eyal Cohen  2
Affiliations
Review

Children with medical complexity in Canada

Tammie Dewan et al. Paediatr Child Health. 2013 Dec.

Abstract
in English, French

The burden of chronic disease is placing pressure on the Canadian health care system. A small but important chronic disease population is children with medical complexity, defined as individuals with: high family-identified needs; complex chronic disease necessitating specialized care; functional disability; and high health care utilization. These patients present a challenge to community providers who are expected to provide holistic care and manage complex issues, often with a paucity of services and supports. Alternative models of care may address the complex needs of this population. In addition, strategies can be implemented in community practices that may assist with the care of children with medical complexity such as collaborative care, engagement of key workers, focus on goal-directed care and use of care plans. The paediatric community should engage in health care reform discussions focused on chronic disease to ensure that the complex needs of these children are met.

Le fardeau des maladies chroniques accable le système de santé canadien. Les enfants présentant des complexités médicales constituent une population, petite mais importante, définie comme composée de personnes dont la famille a des besoins considérables, dont la maladie chronique complexe exige des soins spécialisés, qui souffrent d’une incapacité fonctionnelle et qui utilisent beaucoup les soins de santé. Ces patients représentent un défi pour les dispensateurs de soins communautaires, qui doivent fournir des soins globaux et prendre en charge des problèmes complexes, souvent malgré un manque de services et de soutien. D’autres modèles de soins peuvent répondre aux besoins complexes de cette population. En outre, des stratégies peuvent être mises en œuvre dans les pratiques communautaires afin de contribuer aux soins des enfants présentant des complexités médicales, telles que les soins coopératifs, la participation de travailleurs clés, une orientation vers des soins axés sur des objectifs et l’utilisation de plans de soins. Le milieu de la pédiatrie devrait entamer des discussions en vue d’une réforme de la santé qui répondra aux besoins complexes de ces enfants.

Keywords: Canada; Children; Children with medical complexity; Complex disorders; Guidance; Health care reform.

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Figures

Figure 1)
Figure 1)
Definitional framework for children with medical complexity. Reproduced with permission from Pediatrics 127(3):529–38, © 2011, by the American Academy of Pediatrics. CCC Complex chronic conditions
Figure 2)
Figure 2)
Example of a care map for a child with medical complexity
See this image and copyright information in PMC

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References

    1. Bethell CD, Read D, Stein REK, Blumberg SJ, Wells N, Newacheck PW. Identifying children with special health care needs: Development and evaluation of a short screening instrument. Ambul Pediatr. 2002;2:38–48. - PubMed
    1. Cohen E, Kuo DZ, Agrawal R, et al. Children with medical complexity: An emerging population for clinical and research initiatives. Pediatrics. 201127:529–38. - PMC - PubMed
    1. Miller AR, Condin CJ, McKellin WH, Shaw N, Klassen AF, Sheps S. Continuity of care for children with complex chronic health conditions: Parents’ perspectives. BMC Health Serv Res. 2009;9:242. - PMC - PubMed
    1. Cohen E, Berry JG, Camacho X, Anderson G, Wodchis W, Guttmann A. Patterns and costs of health care use of children with medical complexity. Pediatrics. 2012;130:e1463–70. - PMC - PubMed
    1. Simon TD, Berry J, Feudtner C, et al. Children with complex chronic conditions in inpatient hospital settings in the United States. Pediatrics. 2010;126:647–55. - PMC - PubMed

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