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Cited by 90Adolescent and Pediatric HealthcareChild and Adolescent HealthPrimary Care and Health Outcomes

Hospital-Based Comprehensive Care Programs for Children With Special Health Care Needs: A Systematic Review

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Cohen, Eyal, Jovcevska, Vesna, Kuo, Dennis Z., Mahant, Sanjay·2011·Archives of Pediatrics & Adolescent Medicine
DOI 10.1001/archpediatrics.2011.74PMC PMC3932746
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Abstract

OBJECTIVE: To examine the effectiveness of hospital-based comprehensive care programs in improving the quality of care for children with special health care needs. DATA SOURCES: A systematic review was conducted using Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Sociological Abstracts SocioFile, and Web of Science. STUDY SELECTION: Evaluations of comprehensive care programs for categorical (those with single disease) and noncategorical groups of children with special health care needs were included. Selected articles were reviewed independently by 2 raters. DATA EXTRACTION: Models of care focused on comprehensive care based at least partially in a hospital setting. The main outcome measures were the proportions of studies demonstrating improvement in the Institute of Medicine's quality-of-care domains (effectiveness of care, efficiency of care, patient or family centeredness, patient safety, timeliness of care, and equity of care). DATA SYNTHESIS: Thirty-three unique programs were included, 13 (39%) of which were randomized controlled trials. Improved outcomes most commonly reported were efficiency of care (64% [49 of 76 outcomes]), effectiveness of care (60% [57 of 95 outcomes]), and patient or family centeredness (53% [10 of 19 outcomes). Outcomes less commonly evaluated were patient safety (9% [3 of 33 programs]), timeliness of care (6% [2 of 33 programs]), and equity of care (0%). Randomized controlled trials occurred more frequently in studies evaluating categorical vs noncategorical disease populations (11 of 17 [65%] vs 2 of 16 [17%], P = .008). CONCLUSIONS: Although positive, the evidence supporting comprehensive hospital-based programs for children with special health care needs is restricted primarily to nonexperimental studies of children with categorical diseases and is limited by inadequate outcome measures. Additional high-quality evidence with appropriate comparative groups and broad outcomes is necessary to justify continued development and growth of programs for broad groups of children with special health care needs.

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  • Previous studies on integrated care are mostly about narrowly defined care models.

    “or about narrowly defined care models.13”

    From Integrated care for children and young people with special health and care needs: a systematic review (2024) · cites this paper as [13]

    The COMMENT section says evidence on comprehensive hospital-based programs for children with special health care needs is limited primarily to studies of children with categorical diseases, and that most high-quality evidence focuses on single disease groups. This supports the narrower point about disease-specific studies, but the paper does not establish that previous integrated-care studies in general mostly concern narrowly defined models. No page number is provided in our copy. (LLM, conf=0.82)

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Cited by

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Authors
Cohen, E., Jovcevska, V., Kuo, D. Z., & Mahant, S.
Affiliations
  • Hospital for Sick Children (CA)
  • University of Toronto (CA)
ORCID
Venue
Archives of Pediatrics & Adolescent Medicine
Publisher
American Medical Association (AMA)
Published
2011-06-01
Volume
165
Issue
6
Pages
554-61
ISSN
1072-4710 (ISSN-L)
DOI
10.1001/archpediatrics.2011.74
PMC
PMC3932746
OpenAlex
W2036397043
Cited by
90
References
2
Citations by year
2026: 6 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 10 · 2021: 2 · 2020: 7 · 2019: 9 · 2018: 6 · 2017: 4 · 2016: 9 · 2015: 3 · 2014: 8 · 2013: 3 · 2012: 8
FWCI
15.84
Type
journal article
Language
en
Open access
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Center for Research Resources (KL2RR029883)
Topics
  • Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
  • Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords
children with special health care needs, quality of care, patient-centered care, family-centered care, patient safety, timeliness of care, health care equity, efficiency of care, health care effectiveness, models of care
MeSH terms
Canada, Child, Child Health Services, Child Welfare, Child, Preschool, Comprehensive Health Care, Female, Hospitals, Humans, Infant, Male, Quality Control, Program Evaluation, Outcome Assessment, Health Care, Risk Assessment, Children with Disabilities, Disabled Children, Needs Assessment

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