Home health care for children with medical complexity: Workforce gaps, policy, and future directions

Carolyn C. Foster*, Rishi K. Agrawal, Matthew M. Davis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

106 Scopus citations

Abstract

With the medical and surgical advances of recent decades, a growing proportion of children rely on home-based care for daily health monitoring and care tasks. However, a dearth of available home health care providers with pediatric training to serve children and youth with medical complexity markedly limits the current capacity of home health care to meet the needs of patients and their families. In this article we analyze the workforce gaps, payment models, and policy challenges unique to home health care for children and youth with medical complexity, including legal challenges brought by families because of home nursing shortages. We propose a portfolio of solutions to address the current failures, including payment reform, improved coordination of services and pediatric home health training through partnerships with child-focused health systems, telehealth-enabled opportunities to bridge current workforce gaps, and the better alignment of pediatric care with the needs of adult-focused long-term services and supports.

Original languageEnglish (US)
Pages (from-to)987-993
Number of pages7
JournalHealth Affairs
Volume38
Issue number6
DOIs
StatePublished - Jun 2019

Funding

The writing of this article was funded by a grant from the Lucile Packard Foundation for Children's Health, Palo Alto, California (Grant No. 2017-00219). This is an open access article

ASJC Scopus subject areas

  • Health Policy

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