Little is known about the health care resource use patterns of children with special health care needs (CSHCN). Even less is known about the effects of primary care coordination efforts (medical homes) for these children. We present baseline estimates of resource use for a group of CSHCN in Boston as well as preliminary estimates of the effects of a medical home intervention. CSHCN ages 0-18 in 6 pediatric primary care practices in the Boston, MA area were recruited from a list of patients considered as having the most complex medical problems. The majority of these children had 5+ medical concerns. Data were collected directly from the children’s insurers. Most children were enrolled in Massachusetts’ Medicaid program. Quasi-experimental techniques combined with a comparison group of Medicaid children will be utilized as needed to test the effect of the medical home intervention. Average expenditure was approximately $25,000 per child per year. The most expensive categories of service were home health (approximately $10,000; 50% of children) and inpatient (approximately $8,000; 35% of children). Spending on primary care was approximately $1,000 per child per year and about $500 on mental health and other therapeutic services (about 40% of children). These preliminary results suggest that home health care is the largest component of spending even though only 50% of children use it. Almost the same proportion of children utilized mental health or other therapeutic services, yet that spending level is drastically lower. This suggests significant disparities in insurance coverage levels. See web1.tch.harvard.edu/ici/pacctips/
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. List appropriate measures of health care resource use for children with special health care needs 2. Understand the utility of different summary measures of health care resource use
Keywords: Children With Special Needs, Utilization
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.