Home Health Care For Children With Medical Complexity: Workforce Gaps, Policy, And Future Directions
Home Health Care For Children With Medical Complexity: Workforce Gaps, Policy, And Future Directions
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DOI：
10.1377/hlthaff.2018.05531
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发表时间：
2019-06-01
期刊：
影响因子：
9.7
通讯作者：
Davis, Matthew M.
中科院分区：
文献类型：
--
作者：
Foster, Carolyn C.;Agrawal, Rishi K.;Davis, Matthew M.
随着近几十年来医疗和外科手术的进步，越来越多的儿童依靠家庭护理来完成日常健康监测和护理任务。然而，缺乏儿科培训的家庭保健提供者，为儿童和青少年提供医疗复杂性服务，这明显限制了家庭保健满足患者及其家人需求的能力。在这篇文章中，我们分析了劳动力的差距，支付模式，和独特的家庭医疗保健的儿童和青少年的医疗复杂性，包括家庭带来的法律的挑战，因为家庭护理短缺的政策挑战。我们提出了一系列解决方案来解决当前的失败，包括支付改革，通过与以儿童为中心的卫生系统建立伙伴关系，改善服务协调和儿科家庭健康培训，远程医疗使能弥合当前劳动力缺口的机会，以及更好地调整儿科护理与以成人为中心的长期服务和支持的需求。
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.