Healthcare costs and utilization in medically fragile pediatric patients during the first year of care coordination

ABSTRACT

The current study explored the impact of pediatric outpatient care coordination across the first year of enrollment to better understand how services can be stratified for medically fragile children to ensure their needs are met. A retrospective chart review was conducted on pediatric patients with at least one care coordination encounter in a large health system from 2018 to 2020. Utilization, costs, and care coordination encounters were extracted. Data analysis included descriptive statistics and general linear modeling techniques. Children with more severe medical complexity had higher overall utilization and costs than children with moderate medical complexity across the first year. Both moderately and severely medically complex patients saw a reduction healthcare utilization and costs and decreased frequency of care coordination encounters over the first year. Effective and targeted care coordination can reduce healthcare costs and utilization and may equip the family to better navigate the health system.

KEYWORDS:

• Medical home
• children with medical complexity
• chronic conditions
• complex care management
• health care delivery

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The participants of this study did not give written consent for their data to be shared publicly so data is not available.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.