Abstract
The Center for children and youth with special health care needs (CYSHCN) at St. Christopher’s Hospital for Children in Philadelphia is one such model and has grown steadily over the last 10 years. The medical home model embraced by the Center for CYSHCN focuses on care coordination, patient- and family-centered care, and integrated communication tools (such as care plans and medical summaries). The vast majority of CYSHCN treated at the Center during this study ranged in age from 6 to 12 years. Of those children, 82% had public insurance, 17% required home-nursing services, 24% required mobility aids, and 16% required enteral nutritional/feeding tubes. The most common diagnoses included developmental delay, intellectual disability, and cerebral palsy. When compared with CYSHCN enrolled in a statewide medical home program, the severity of the medical conditions of CYSHCN cared for at the Center was statistically significantly higher/more complex.
Highlights
The Medical HomeIn the United States, approximately 15% of all children and youth have special health care needs according to the 20092010 National Survey of Children With Special Health Care Needs (n.d.)
As elucidated by Newacheck et al (1998), the Maternal and Child Health Bureau (MCHB) identifies children and youth with special health care needs (CYSHCN) as those with a “chronic physical, developmental, behavioral or emotional condition” who require “health and related services of a type or amount beyond that required by children generally.”
In many ways, the social and emotional challenges associated with the care of CYSHCN are of paramount concern; the issues CYSHCN and their families face are at times complex and overwhelming
Summary
The Medical HomeIn the United States, approximately 15% of all children and youth have special health care needs according to the 20092010 National Survey of Children With Special Health Care Needs (n.d.). Strickland et al (2004) define the medical home as a framework of health care delivery designed to improve the quality of care received by this vulnerable subset of children In many ways, this model is the highest standard of care for CYSHCN, incorporating elements of care coordination, family-centered care, and comprehensive health assessments (Sia et al, 2004). In a 2007 Pediatrics article on the benefits of practice-wide care coordination, McAllister et al identify a method for implementing a model in which team members outline a “vision for care, a framework of structures and processes, and a position description with specific competencies.”. The CCM advocates family-centered care in which proactive care teams are omnipresent during all aspects of care delivery
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