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Issue title: Complex Care in Pediatrics: Great Progress, Greater Challenges
Subtitle:
Guest editors: Rishi Agrawal
Article type: Research Article
Authors: Johaningsmeir, Sarah A.a; * | Colby, Hollyb | Krauthoefer, Maryb | Simpson, Pippaa | Conceição, Simone C.O.c | Gordon, John B.a
Affiliations: [a] Medical College of Wisconsin, Milwaukee, WI, USA | [b] Children's Hospital of Wisconsin, Milwaukee, WI, USA | [c] University of Wisconsin-Milwaukee, Milwaukee, WI, USA
Correspondence: [*] Corresponding author: Sarah A. Johaningsmeir, Special Needs Program, MS C350, PO Box 1997, Milwaukee, WI 53201-9770, USA. Tel.: +1 414 337 7175; Fax: +1 414 266 2926; E-mail:[email protected]
Abstract: PURPOSE: This study examined the impact of caring for children with medical complexity (CMC) and high resource use on family quality of life (QoL). METHODS: Families of CMC enrolled in a complex care program completed the PedsQL Family Impact module (PedsQL FIM) and Healthcare Satisfaction module (PedsQL HCS) at enrollment then 1 and 2 years after enrollment. Tertiary center resource utilization and staff care coordination time were collected for the two years. RESULTS: PedsQL FIM scores were low at enrollment and did not improve over time. Social Functioning, Worry, and Daily Activities were the lowest domains. PedsQL HCS scores were higher at enrollment, but also failed to improve over the two years. Changes in resource use were not associated with changes in PedsQL FIM or HCS scores. Staff care coordination time was highest for patients with ≥ 10 hospital days per year. CONCLUSION: CMC families' low QoL did not appear to be related to healthcare satisfaction or a shift from inpatient to outpatient resource use. Less staff support for families of CMC who spent more time at home may have contributed to their continued low QoL. Further study is required to identify causes of and strategies for improving the low QoL of families of CMC.
Keywords: Children with medical complexity, complex care, quality of life, family impact
DOI: 10.3233/PRM-150321
Journal: Journal of Pediatric Rehabilitation Medicine, vol. 8, no. 2, pp. 75-82, 2015
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