Children With Medical Complexity: An Emerging Population for Clinical and Research Initiatives
Children With Medical Complexity: An Emerging Population for Clinical and Research Initiatives
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DOI：
10.1542/peds.2010-0910
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发表时间：
2011-03-01
期刊：
影响因子：
8
通讯作者：
Srivastava, Rajendu
中科院分区：
文献类型：
--
作者：
Cohen, Eyal;Kuo, Dennis Z.;Srivastava, Rajendu
患有医疗复杂性（CMC）的儿童具有医疗脆弱性和重症监护需求，现有的卫生保健模式不容易满足这些需求。CMC可能患有先天性或获得性多系统疾病，严重的神经系统疾病，伴有明显的功能障碍，和/或日常生活活动依赖技术。尽管这些儿童面临健康状况和家庭结局不佳的风险，但很少有明确的临床举措和研究努力致力于改善他们的护理。在这篇文章中，我们提出了一个CMC的定义框架，包括大量的家庭确定的服务需求、慢性和严重疾病的特征、功能限制和高卫生保健使用。我们探索现有护理模式的多样性，并应用慢性护理模式的原则来解决CMC的临床需求。最后，我们建议一个研究议程，使用统一的定义来准确地描述人口，并从儿童、家庭和更广泛的医疗保健系统的角度评估结果。儿科2011;127:529 - 538
Children with medical complexity (CMC) have medical fragility and intensive care needs that are not easily met by existing health care models. CMC may have a congenital or acquired multisystem disease, a severe neurologic condition with marked functional impairment, and/or technology dependence for activities of daily living. Although these children are at risk of poor health and family outcomes, there are few well-characterized clinical initiatives and research efforts devoted to improving their care. In this article, we present a definitional framework of CMC that consists of substantial family-identified service needs, characteristic chronic and severe conditions, functional limitations, and high health care use. We explore the diversity of existing care models and apply the principles of the chronic care model to address the clinical needs of CMC. Finally, we suggest a research agenda that uses a uniform definition to accurately describe the population and to evaluate outcomes from the perspectives of the child, the family, and the broader health care system. Pediatrics 2011;127:529-538