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

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 September 23, 2021, https://pedpalascnetlibrary.omeka.net/items/show/17609.

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