Children with medical complexity: creating a framework for care based on the International Classification of Functioning, Disability and Health

Children with medical complexity (CMC) comprise a growing sector of the pediatric population. They are characterized by having severe chronic multiple system conditions, functional limitations, and family needs. While CMC comprise 0.4% to 0.7% of children, they have high healthcare costs and resource utilization, and are thus a key population of interest in health reform efforts. Despite the growth in the development of complex care delivery models, there is little available information to guide the training of diverse professionals in the provision of care that CMC and their families need. We propose a new framework for analysis and discussion based on the components of the International Classification of Function, Disability and Health, with augmentation of further areas of common need identified in this unique population of children. This framework can be used to delineate necessary professional team areas of expertise, guide improvement in care and provider training, and, potentially, to reduce cost as best practices for care are developed and researched.