Hospitals respond to influx of children, adults with complex needs

More healthcare providers are creating special clinics to coordinate care for a patient population that increasingly includes children with complex medical conditions, according to The Wall Street Journal.

Nearly 1 in every 25 children in the United States suffer from complex medical conditions and between one third and half of U.S. pediatric healthcare spending goes to care for them, according to the article. The population is on the rise due to an increase in premature and low-weight births. In addition to the normal complications associated with complex patients of any age, such as the need for extensive, complex therapies, care for pediatric patients can overwhelm their families, and many providers aren't trained to manage them--or receive reimbursement for their care.

These problems have given rise to the creation of complex-care clinics, according to the article. These clinics employ teams of doctors, nurses and social workers who address the full continuum of care and incorporate social factors such as social services and transportation. Research shows failure to address these factors has led to higher pediatric readmissions. The high cost of providing such services leaves many clinics reliant on philanthropy and subsidies from their parent hospitals, Jay Berry, M.D., of the Complex Care Service at Boston Children's Hospital, told the WSJ.

"Care for these kids is unbelievably time-consuming and labor-intensive, and there is no way in the current system there is enough financial incentive for providers to do this," he said. "The success stories are the ones where some hospital, health system or payer has stood up and said, 'We are going to pay for this.'"

Meanwhile, adult patients with chronic or complex problems originating in childhood have not escaped healthcare's notice either. This month, University of Rochester Medicine opened its Complex Care Center, the system's first provider dedicated to adults with chronic childhood-onset conditions. More children with complex care needs survive to adulthood than ever before, and as such, the healthcare system must address their needs as adults, according to the announcement. A Senate paper released last December outlined the need for care coordination and accountable care organization flexibility in care delivery for complex patients.

To learn more:
- read the WSJ article
- here's the Rochester announcement