Impact of Shared Plans of Care on Healthcare Utilization by Children with Special Healthcare Needs and Mental Health Dia
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Impact of Shared Plans of Care on Healthcare Utilization by Children with Special Healthcare Needs and Mental Health Diagnoses Elizabeth Mann1 · Michael Pyevich1 · Patrick Ten Eyck2 · Thomas Scholz3 Accepted: 9 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objectives We assessed how shared plans of care (SPoC), a care coordination tool, impact healthcare utilization of a cohort of children with special healthcare needs (CSHCN) and mental health conditions. Methods Data, including emergency department (ED) visits, hospitalizations, and primary care visits, were collected through chart review of CSHCN. A Poisson generalized linear mixed model was used to analyze healthcare utilization data for CSHCN. Results Our results showed a decrease in primary care visits, hospitalizations, and ED visits for CSHCN after SPoC imple‑ mentation, though only primary care visits reached significance. Mental health care visits were specifically found to decrease by 39% following employment of SPoC. Conclusions for Practice The use of SPoCs in CSHCN had a positive impact on healthcare utilization suggesting widespread use of this tool improved care coordination in this population. Keywords Children with special healthcare needs · Mental health · Care coordination tool · Medical home · Shared plans of care
Significance What is already known on this subject? Healthcare utiliza‑ tion by children with special health care needs (CSHCN) can be influenced by care coordination activities. Shared plans of care (SPoC), comprehensive care coordination documents that focus on patient and family goal setting, can improve * Thomas Scholz thomas‑[email protected] Elizabeth Mann elizabeth‑n‑[email protected] Michael Pyevich michael‑[email protected] Patrick Ten Eyck patrick‑[email protected] 1
Carver College of Medicine, University of Iowa, 220 River Street, Iowa City, IA 52246, USA
2
Institute for Clinical and Translational Science, University of Iowa, SW44-M General Hospital, 100 Hawkins Drive, Iowa City, IA 52242, USA
3
Department of Pediatrics, Child and Community Health, 247 CDD, 100 Hawkins Drive, Iowa City, IA 52242, USA
parental satisfaction and decrease in hospitalizations and emergency department visits for CSHCN. What this study adds? This study provided an assessment of a SPoC in CSHCN with behavioral and mental health conditions and demonstrated a positive impact on healthcare utilization indicating the value of a standardized care coordination tool.
Introduction Children with special healthcare needs (CSHCN) are those who are at risk for chronic physical, developmental, and behavioral conditions that utilize healthcare services beyond those of children in general (Merle McPherson et al. 1998). For CSHCN, care coordination implemented though a medi‑ cal home is associated with fewer out of pocket expenses for families, fewer school absences, decreased time spent coor‑ dinating care by parents (Turchi et al. 2009), fewer emer‑ gency department visits and hospitalizations (Coo
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