The researchers note that improved care delivery and coordination could lead to reduced hospital utilization and better patient outcomes. Children with severe neurologic conditions commonly have additional health problems, such as respiratory and feeding problems, that make their care needs more complex. Yet studies indicate that pediatric providers often feel unprepared to assess and treat them.
The result, the researchers write, is uncoordinated, crisis-driven care that can lead to a disproportionate share of emergency care and frequent re-hospitalizations that drive up costs. "We're nervous that many children with neurologic impairment are without a healthcare provider who is taking charge of their care and making sure that all of their health care needs are adequately addressed," says Berry.
In the study, inpatient utilization increased most markedly among neurologically impaired adolescents. Across all hospitals, this group of children had a 28 percent increase in hospitalizations from 1997 to 2006, while children of the same age without neurologic diagnoses had an 8.4 percent decrease in hospitalizations.
"Children with severe neurologic impairment tend to have more health problems as they reach adolescence and young adulthood," says Berry. "This coincides with a difficult period where they begin to outgrow their pediatric providers, but have trouble transferring their care to adult providers."
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Children's Hospital Boston