The Moral Imperative of Home Health Care for Children: Beyond the Financial Case.

Abstract

* Abbreviations: CMC — : children with medical complexity HCN — : home care nursing Children with medical complexity (CMC) are defined as those children with medical fragility, technology dependence, functional impairment, and intensive care needs that are not easily met by existing care models.1 Common underlying syndromes include congenital or acquired neurologic diseases with manifestations over several organ systems, often resulting in the need for life support devices, such as tracheostomies, home ventilation, enteral feeding tubes, or home intravenous therapies. The services that allow for these children to be cared for at home have been the standard of care since the creation of the Katie Beckett waiver in 1986.2 CMC typically acquire the need for home care services during acute hospitalization, and arranging home care services is a vital part of discharge planning. In their article “Home Health Care Availability and Discharge Delays in Children With Medical Complexity,” Maynard et al3 report the extent to which discharges of CMC were delayed primarily because of the unavailability of home care nursing (HCN). Among 185 CMC discharged from 4 children’s hospitals in Minnesota, discharge … Address correspondence to Garey Noritz, MD, Division of Complex Care, Department of Pediatrics, Nationwide Children’s Hospital, 700 Children’s Dr, Columbus, OH 43205. E-mail: garey.noritz{at}nationwidechildrens.org