Caring for Children with Medical Complexity: Definitions, Challenges and Solutions

Increasing prevalence of children with complex and chronic diseases has occurred in the last half century and will likely continue to occur. These children, their parental caregivers, their families and the health care system are challenged in providing seamless coordinated care that optimizes outcomes in an effective and efficient manner. This paper outlines some potential solutions including clarifying definitions of the population and evaluations of existing and evolving models of care such as the chronic care model, the primary care medical home and non-primary care practice based models, such as comprehensive clinics focused on a specific disease or population, comprehensive clinics focused on a non-categorical population (not focused on a single/limited set of disease(s)), interventions focused on home care; and, other models focusing on more limited types of interventions or policy change. Ongoing growth in impact of complex chronic disease of childhood demands increased attention across sectors of care as an immediate area of focus for child health policy.