Pediatric care coordination and risk tiering: Moving beyond claims data
Title
Pediatric care coordination and risk tiering: Moving beyond claims data
Creator
Swann-Thomsen HE; Vineyard J; Hanks J; Hofacer R; Sitts C; Flint H; Tivis R
Identifier
Publisher
Journal of Pediatric Rehabilitation Medicine
Date
2021
Subject
care coordination; chronic conditions; acuity; Pediatric complex care
Description
PURPOSE: The goal of this study was to evaluate the performance of a pediatric stratification tool that incorporates health and non-medical determinants to identify children and youth with special health care needs (CYSHCN) patients according to increasing levels of complexity and compare this method to existing tools for pediatric populations. METHODS: This retrospective cohort study examined pediatric patients aged 0 to 21 years who received care at our institution between 2012 and 2015. We used the St. Luke's Children's Acuity Tool (SLCAT) to evaluate mean differences in dollars billed, number of encounters, and number of problems on the problem list and compared the SLCAT to the Pediatric Chronic Conditions Classification System version2 (CCCv2). RESULTS: Results indicate that the SLCAT assigned pediatric patients into levels reflective of resource utilization and found that children with highly complex chronic conditions had significantly higher utilization than those with mild and/or moderate complex conditions. The SLCAT found 515 patients not identified by the CCCv2. Nearly half of those patients had a mental/behavioral health diagnosis. CONCLUSIONS: The findings of this study provide evidence that a tiered classification model that incorporates all aspects of a child's care may result in more accurate identification of CYSHCN. This would allow for primary care provider and care coordination teams to match patients and families with the appropriate amount and type of care coordination services.
Rights
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Citation List Month
July 2021 List
URL Address
Collection
Citation
Swann-Thomsen HE; Vineyard J; Hanks J; Hofacer R; Sitts C; Flint H; Tivis R, “Pediatric care coordination and risk tiering: Moving beyond claims data,” Pediatric Palliative Care Library, accessed February 15, 2025, https://pedpalascnetlibrary.omeka.net/items/show/17609.