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

Elizabeth S Barnert^{1

2}, Ryan J Coller³, Bergen B Nelson⁴, Lindsey R Thompson^{5

6}, John Tran⁵, Vincent Chan⁵, Cesar Padilla^{5

6

7

8}, Thomas S Klitzner^{5

6}, Moira Szilagyi^{5

6}, Paul J Chung^{5

9

10

11}

Affiliations

¹ Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave MDCC, Los Angeles, CA, 90095, USA. ebarnert@mednet.ucla.edu.
² Children's Discovery & Innovation Institute, UCLA Mattel Children's Hospital, 10833 Le Conte Avenue, 12-311 MDCC, Los Angeles, CA, 90095, USA. ebarnert@mednet.ucla.edu.
³ Department of Pediatrics, University of Wisconsin-Madison, Office H4/410 CSC, 600 Highland Ave, Madison, WI, 53792, USA.
⁴ Children's Hospital of Richmond at VCU, 1000 East Broad Street, Richmond, VA, 23298, USA.
⁵ Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave MDCC, Los Angeles, CA, 90095, USA.
⁶ Children's Discovery & Innovation Institute, UCLA Mattel Children's Hospital, 10833 Le Conte Avenue, 12-311 MDCC, Los Angeles, CA, 90095, USA.
⁷ Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
⁸ W. P. Carey School of Business, Arizona State University, Business Administration, 300 E Lemon St., Tempe, AZ, 85287, USA.
⁹ RAND Health, RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, USA.
¹⁰ Department of Health Policy & Management, UCLA Fielding School of Public Health, 650 Charles Young Dr. S., 31-269 CHS Box 951772, Los Angeles, CA, 90095, USA.
¹¹ Department of Health Systems Science, Kaiser Permanente School of Medicine, 98 South Los Robles Ave., Pasadena, CA, 91101, USA.

PMID: 31218608
DOI: 10.1007/s10995-019-02752-1

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

Elizabeth S Barnert et al. Matern Child Health J. 2019 Sep.

. 2019 Sep;23(9):1167-1176.

doi: 10.1007/s10995-019-02752-1.

Authors

Affiliations

¹ Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave MDCC, Los Angeles, CA, 90095, USA. ebarnert@mednet.ucla.edu.
² Children's Discovery & Innovation Institute, UCLA Mattel Children's Hospital, 10833 Le Conte Avenue, 12-311 MDCC, Los Angeles, CA, 90095, USA. ebarnert@mednet.ucla.edu.
³ Department of Pediatrics, University of Wisconsin-Madison, Office H4/410 CSC, 600 Highland Ave, Madison, WI, 53792, USA.
⁴ Children's Hospital of Richmond at VCU, 1000 East Broad Street, Richmond, VA, 23298, USA.
⁵ Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave MDCC, Los Angeles, CA, 90095, USA.
⁶ Children's Discovery & Innovation Institute, UCLA Mattel Children's Hospital, 10833 Le Conte Avenue, 12-311 MDCC, Los Angeles, CA, 90095, USA.
⁷ Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
⁸ W. P. Carey School of Business, Arizona State University, Business Administration, 300 E Lemon St., Tempe, AZ, 85287, USA.
⁹ RAND Health, RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, USA.
¹⁰ Department of Health Policy & Management, UCLA Fielding School of Public Health, 650 Charles Young Dr. S., 31-269 CHS Box 951772, Los Angeles, CA, 90095, USA.
¹¹ Department of Health Systems Science, Kaiser Permanente School of Medicine, 98 South Los Robles Ave., Pasadena, CA, 91101, USA.

PMID: 31218608
DOI: 10.1007/s10995-019-02752-1

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.

Keywords: Children with medical complexity; Children with special health care needs; Complex chronic conditions; Health outcomes; Population health.

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References

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

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

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical