Medical complexity among children with special health care needs

In this article, Dr. Ryan Coller et al. sought to identify subgroups of U.S. children with special health care needs and characterize key health outcomes by subgroup. They used a latent class analysis to identify 4 unique subgroups: (1) broad functional impairment with extensive health care, (2) broad functional impairment alone, (3) predominant physical impairment requiring family-delivered care, and (4) physical impairment alone. Children from class 1 had the highest ED visit rates and hospitalization odds, and the lowest odds of having a medical home. Despite having more shared decision making and medical home attributes, children in class 3 had more ED visits and missed school than children in class 2. However, children in class 2 experienced more cost-related difficulties, care delays, and parents needing to stop work.

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