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Continuity of Care for Sickest Kids Brings Benefits, Savings

Wisconsin program helps coordinate medical care for children with special needs

FRIDAY, Oct. 12 (HealthDay News) -- A Wisconsin program that creates a "medical home" for children requiring frequent medical care for complex needs cut down on hospitalization days and charges for hospital care, and increased the use of outpatient services, according to research published in the October issue of the Archives of Pediatrics & Adolescent Medicine.

John B. Gordon, M.D., of the Medical College of Wisconsin in Milwaukee, and colleagues analyzed pre-enrollment and post-enrollment data from 227 children who were accepted into the special needs program created by the college and the Children's Hospital of Wisconsin. In the program, a physician and/or a nurse case-manager worked with the children's primary care physician and tertiary care specialists to provide continuity of care for the children and their families.

After enrollment, children in the program had significantly fewer admissions (from 572 to 518 over equal periods before and after enrollment) and hospitalized days (from 7,926 to 3,831). Clinic visits rose (3,150 to 5,420), and hospital charges fell ($39.1 million to $24.4 million).

"We believe that the key interventions by the special needs program were (1) partnering with the family and primary care physician, (2) familiarity with the child's condition, (3) close involvement during hospitalizations, and (4) proactive outpatient care. The partnership allowed the special needs program to focus on care coordination, the primary care physician on primary care, and the family on their goals for the child," the authors write.

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