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A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs.
Arch Pediatr Adolesc Med. 2007 Oct; 161(10):937-44.AP

Abstract

OBJECTIVE

To evaluate the impact of a tertiary care center special needs program that partners with families and primary care physicians to ensure seamless inpatient and outpatient care and assist in providing medical homes.

DESIGN

Up to 3 years of preenrollment and postenrollment data were compared for patients in the special needs program from July 1, 2002, through June 30, 2005.

SETTING

A tertiary care center pediatric hospital and medical school serving urban and rural patients.

PARTICIPANTS

A total of 227 of 230 medically complex and fragile children and youth with special needs who had a wide range of chronic disorders and were enrolled in the special needs program.

INTERVENTIONS

Care coordination provided by a special needs program pediatric nurse case manager with or without a special needs program physician.

MAIN OUTCOME MEASURES

Preenrollment and postenrollment tertiary care center resource utilization, charges, and payments.

RESULTS

A statistically significant decrease was found in the number of hospitalizations, number of hospital days, and tertiary care center charges and payments, and an increase was found in the use of outpatient services. Aggregate data revealed a decrease in hospital days from 7926 to 3831, an increase in clinic visits from 3150 to 5420, and a decrease in tertiary care center payments of $10.7 million. The special needs program budget for fiscal year 2005 had a deficit of $400,000.

CONCLUSION

This tertiary care-primary care partnership model improved health care and reduced costs with relatively modest institutional support.

Authors+Show Affiliations

Department of Pediatrics, Medical College of Wisconsin, Children's Research Institute, and Special Needs Program, Children's Hospital of Wisconsin, Mail Stop C350, 9000 W Wisconsin Ave, Milwaukee, WI 53226, USA. jgordon@mcw.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17909136

Citation

Gordon, John B., et al. "A Tertiary Care-primary Care Partnership Model for Medically Complex and Fragile Children and Youth With Special Health Care Needs." Archives of Pediatrics & Adolescent Medicine, vol. 161, no. 10, 2007, pp. 937-44.
Gordon JB, Colby HH, Bartelt T, et al. A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs. Arch Pediatr Adolesc Med. 2007;161(10):937-44.
Gordon, J. B., Colby, H. H., Bartelt, T., Jablonski, D., Krauthoefer, M. L., & Havens, P. (2007). A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs. Archives of Pediatrics & Adolescent Medicine, 161(10), 937-44.
Gordon JB, et al. A Tertiary Care-primary Care Partnership Model for Medically Complex and Fragile Children and Youth With Special Health Care Needs. Arch Pediatr Adolesc Med. 2007;161(10):937-44. PubMed PMID: 17909136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A tertiary care-primary care partnership model for medically complex and fragile children and youth with special health care needs. AU - Gordon,John B, AU - Colby,Holly H, AU - Bartelt,Tera, AU - Jablonski,Debra, AU - Krauthoefer,Mary L, AU - Havens,Peter, PY - 2007/10/3/pubmed PY - 2007/11/14/medline PY - 2007/10/3/entrez SP - 937 EP - 44 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 161 IS - 10 N2 - OBJECTIVE: To evaluate the impact of a tertiary care center special needs program that partners with families and primary care physicians to ensure seamless inpatient and outpatient care and assist in providing medical homes. DESIGN: Up to 3 years of preenrollment and postenrollment data were compared for patients in the special needs program from July 1, 2002, through June 30, 2005. SETTING: A tertiary care center pediatric hospital and medical school serving urban and rural patients. PARTICIPANTS: A total of 227 of 230 medically complex and fragile children and youth with special needs who had a wide range of chronic disorders and were enrolled in the special needs program. INTERVENTIONS: Care coordination provided by a special needs program pediatric nurse case manager with or without a special needs program physician. MAIN OUTCOME MEASURES: Preenrollment and postenrollment tertiary care center resource utilization, charges, and payments. RESULTS: A statistically significant decrease was found in the number of hospitalizations, number of hospital days, and tertiary care center charges and payments, and an increase was found in the use of outpatient services. Aggregate data revealed a decrease in hospital days from 7926 to 3831, an increase in clinic visits from 3150 to 5420, and a decrease in tertiary care center payments of $10.7 million. The special needs program budget for fiscal year 2005 had a deficit of $400,000. CONCLUSION: This tertiary care-primary care partnership model improved health care and reduced costs with relatively modest institutional support. SN - 1072-4710 UR - https://www.unboundmedicine.com/medline/citation/17909136/A_tertiary_care_primary_care_partnership_model_for_medically_complex_and_fragile_children_and_youth_with_special_health_care_needs_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpedi.161.10.937 DB - PRIME DP - Unbound Medicine ER -