Benefits of Care Coordination for Children with Complex Disease: A Pilot Medical Home Project in a Resident Teaching Clinic
Benefits of Care Coordination for Children with Complex Disease: A Pilot Medical Home Project in a Resident Teaching Clinic
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DOI：
10.1016/j.jpeds.2009.12.012
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发表时间：
2010-06-01
影响因子：
5.1
通讯作者：
Chang, Ruey-Kang R.
中科院分区：
文献类型：
--
作者：
Klitzner, Thomas S.;Rabbitt, Leslie A.;Chang, Ruey-Kang R.
目的通过对加州洛杉矶大学住院医师教育门诊医疗资源使用变化的分析，研究综合护理协调在复杂疾病儿童中的整合情况。研究设计加州大学洛杉矶分校的儿科医疗之家项目设计包括4个基本要素：1）60分钟的入院预约; 2）随访时间是标准访视时间的两倍; 3）获得“家庭联络员”; 4）家庭笔记本（“关于我的一切”活页夹）。从43例患者的初始队列中，对30例患者的就诊数据进行分析，以确定门诊、急诊、急诊科（艾德）和住院服务的使用情况。结果每位患者的平均艾德就诊次数从登记前的1.1 +/- 1.7次下降到登记后的0.5 +/- 0.9次（P= 0.02）。然而，没有显着的变化，发现在使用任何其他的医疗资源studyed.Conclusions的原则，根据医疗之家到门诊儿科住院教学诊所的护理协调计划，不仅可以作为一个培训工具，儿科住院医师，但也创造了有利的改变医疗资源的使用。（J Pediatr 2010;156：1006-10）。
Objective To study the integration of comprehensive care coordination for children with complex disease in our resident education clinic at University of California Los Angeles by analyzing alterations in medical resource use.Study design The Pediatric Medical Home Project at University of California Los Angeles was designed to include 4 basic elements: 1) 60-minute intake appointment; 2) follow-up appointments twice the length of a standard visit; 3) access to a "family liaison''; and 4) a family notebook ("All about Me'' binder). From the initial cohort of 43 patients, encounter data on 30 were analyzed to determine use of outpatient, urgent, emergency department (ED), and inpatient services. Encounters for each patient were compared for a period of 1 year before and 1 year after enrollment.Results The average number of ED visits per patient decreased from 1.1 +/- 1.7 before enrollment to 0.5 +/- 0.9 after medical home enrollment (P=.02). However, no significant change was found in use of any of the other health care resources studied.Conclusions Incorporating a program of care coordination according to the principles of the medical home into an outpatient pediatric residency teaching clinic may not only serve as a training vehicle for pediatric residents, but also create favorable alterations in medical resource use. (J Pediatr 2010;156:1006-10).