Children with medical complexity: An emerging population for clinical and research initiatives

Eyal Cohen*, Dennis Z. Kuo, Rishi Agrawal, Jay G. Berry, Santi K.M. Bhagat, Tamara D. Simon, Rajendu Srivastava

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

451 Scopus citations

Abstract

Children with medical complexity (CMC) have medical fragility and intensive care needs that are not easily met by existing health care models. CMC may have a congenital or acquired multisystem disease, a severe neurologic condition with marked functional impairment, and/or technology dependence for activities of daily living. Although these children are at risk of poor health and family outcomes, there are few well-characterized clinical initiatives and research efforts devoted to improving their care. In this article, we present a definitional framework of CMC that consists of substantial family-identified service needs, characteristic chronic and severe conditions, functional limitations, and high health care use. We explore the diversity of existing care models and apply the principles of the chronic care model to address the clinical needs of CMC. Finally, we suggest a research agenda that uses a uniform definition to accurately describe the population and to evaluate outcomes from the perspectives of the child, the family, and the broader health care system.

Original languageEnglish (US)
Pages (from-to)529-538
Number of pages10
JournalPediatrics
Volume127
Issue number3
DOIs
StatePublished - Mar 2011

Keywords

  • Chronic illness/conditions
  • Definitions
  • Delivery of care
  • Medical complexity
  • Special needs

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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