{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:59:32Z","timestamp":1792069172688,"version":"4.4.0"},"reference-count":64,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi260317-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Children with medical complexity often require complicated home care regimens, yet health care safety issues in community settings have been rarely described. Systems-level approaches to addressing patient safety in pediatric home health care (HHC) also remain nascent. Quantifying and categorizing HHC staff incidents is a first step toward preventing the occurrence of safety events in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260317-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the rates and types of patient safety events within a US national pediatric population receiving HHC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260317-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This was a retrospective cohort study (September 1, 2022, to August 31, 2023) that used staff incident reports from a pediatric HHC agency with sites in 11 US states. Participants were patients aged younger than 21 years receiving HHC within the study year, excluding psychiatric HHC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260317-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Days of HHC receipt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260317-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Rate and type of staff-reported patient safety events per 1000 HHC-days, reviewed by 3 trained clinician reviewers, and classified using the National Coordinating Council for Medication Error Reporting and Prevention Index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260317-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study identified 2901 children (males, 1710 [59.0%]) who received a median of 98.0 (IQR, 14.0-312.0) days of HHC. The mean (SD) age was 8.7 (5.3) years. A total of 678 incident reports were filed for 348 children (11.9%). Of these, 307 (45.3%) were patient safety events, including 168 harmful errors (54.7%), 110 nonharmful errors (35.8%), and 22 hazards (7.2%). This equated to a mean (SD) of 0.68 (4.40) patient safety events per 1000 HHC-days. Errors most frequently involved medications (108 [38.8%]) and implanted devices (91 [32.7%]). Harmful errors were most frequently related to non\u2013pressure-related skin injuries (45 [26.8%]) and falls (30 [17.9%]). Approximately half of all errors required additional monitoring (133 [47.8%]) and 45 (16.2%) required emergency care. Patient safety events were more likely in children with invasive home ventilation compared with other types of implanted medical technology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260317-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this cohort study of children receiving HHC, more than 1 in 10 had a reported incident, of which approximately half were patient safety related. This work provides new data about pediatric HHC safety. Further work should explore factors contributing to and preventing health care\u2013related harms to children at home and include parent perspectives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.10321","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T15:00:20Z","timestamp":1777906820000},"page":"e2610321","source":"Crossref","is-referenced-by-count":1,"title":["Patient Safety Events Among Children Receiving Home Health Care"],"prefix":"10.1001","volume":"9","author":[{"given":"Carolyn C.","family":"Foster","sequence":"first","affiliation":[{"name":"Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Illinois"},{"name":"Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Walsh","sequence":"additional","affiliation":[{"name":"Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"High","sequence":"additional","affiliation":[{"name":"Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo","family":"Barrera","sequence":"additional","affiliation":[{"name":"Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara L.","family":"Coleman","sequence":"additional","affiliation":[{"name":"Bluebird Consulting, LLC, Lorton, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret M.","family":"Storey","sequence":"additional","affiliation":[{"name":"College of Liberal Arts and Social Sciences, DePaul University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikki","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Family Voices National, Concord, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbi Simmons","family":"Harris","sequence":"additional","affiliation":[{"name":"Family Voices Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny","family":"Valdez","sequence":"additional","affiliation":[{"name":"Department of Applied Health Science, Indiana University School of Public Health\u2013Bloomington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Haywood","sequence":"additional","affiliation":[{"name":"Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois"},{"name":"Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Lagu","sequence":"additional","affiliation":[{"name":"Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois"},{"name":"Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois"},{"name":"Division of Hospital Medicine, Department of Medicine, Northwestern Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen E.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Harvard Medical School, Boston, Massachusetts"},{"name":"Division of General Pediatrics, Boston Children\u2019s Hospital, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisa","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Harvard Medical School, Boston, Massachusetts"},{"name":"Division of General Pediatrics, Boston Children\u2019s Hospital, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole E.","family":"Werner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"issue":"3","key":"zoi260317r3","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1542\/peds.2010-0910","article-title":"Children with medical complexity: an emerging population for clinical and research initiatives.","volume":"127","author":"Cohen","year":"2011","journal-title":"Pediatrics"},{"issue":"6","key":"zoi260317r4","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-053913","article-title":"Family safety reporting in medically complex children: parent, staff, and leader perspectives.","volume":"149","author":"Khan","year":"2022","journal-title":"Pediatrics"},{"issue":"3","key":"zoi260317r5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2025-073171","article-title":"Home health care of children, adolescents and young adults with complex medical needs: clinical report.","volume":"156","author":"Lin","year":"2025","journal-title":"Pediatrics"},{"issue":"4","key":"zoi260317r6","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1177\/10848223231167878","article-title":"Access and quality of pediatric home healthcare: a systematic review.","volume":"35","author":"Foster","year":"2023","journal-title":"Home Health Care Manag Pract"},{"issue":"2","key":"zoi260317r7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2024-067966","article-title":"Home health care research for children with disability and medical complexity.","volume":"155","author":"Foster","year":"2025","journal-title":"Pediatrics"},{"issue":"8","key":"zoi260317r9","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.22818","article-title":"Complexity of medication regimens for children with neurological impairment.","volume":"4","author":"Feinstein","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"10","key":"zoi260317r10","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1001\/jamapediatrics.2019.2672","article-title":"Identification of children with high-intensity neurological impairment.","volume":"173","author":"Thomson","year":"2019","journal-title":"JAMA Pediatr"},{"key":"zoi260317r11","article-title":"Making polypharmacy safer for children with medical complexity.","volume":"254","author":"Feinstein","year":"2022","journal-title":"J Pediatr"},{"issue":"1","key":"zoi260317r13","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1177\/1367493511420186","article-title":"The daily patterns of time use for parents of children with complex needs: a systematic review.","volume":"16","author":"McCann","year":"2012","journal-title":"J Child Health Care"},{"issue":"1","key":"zoi260317r14","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s41687-023-00549-z","article-title":"Parental self-efficacy managing a child\u2019s medications and treatments: adaptation of a PROMIS measure.","volume":"7","author":"Foster","year":"2023","journal-title":"J Patient Rep Outcomes"},{"issue":"2","key":"zoi260317r15","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-055098","article-title":"Family safety reporting in hospitalized children with medical complexity.","volume":"150","author":"Mercer","year":"2022","journal-title":"Pediatrics"},{"issue":"3","key":"zoi260317r16","doi-asserted-by":"publisher","first-page":"134","DOI":"10.12788\/jhm.3505","article-title":"Readmissions following hospitalization for infection in children with or without medical complexity.","volume":"16","author":"Markham","year":"2021","journal-title":"J Hosp Med"},{"issue":"6","key":"zoi260317r17","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1038\/s41372-018-0055-5","article-title":"Health-care spending and utilization for children discharged from a neonatal intensive care unit.","volume":"38","author":"Kuo","year":"2018","journal-title":"J Perinatol"},{"issue":"12","key":"zoi260317r18","doi-asserted-by":"publisher","first-page":"2199","DOI":"10.1377\/hlthaff.2014.0828","article-title":"Children with medical complexity and Medicaid: spending and cost savings.","volume":"33","author":"Berry","year":"2014","journal-title":"Health Aff (Millwood)"},{"issue":"6","key":"zoi260317r19","doi-asserted-by":"publisher","first-page":"e1521","DOI":"10.1542\/peds.2015-0871","article-title":"Comparison of health care spending and utilization among children with Medicaid insurance.","volume":"136","author":"Kuo","year":"2015","journal-title":"Pediatrics"},{"issue":"4","key":"zoi260317r20","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-0682","article-title":"Trends in health care spending for children in Medicaid with high resource use.","volume":"138","author":"Agrawal","year":"2016","journal-title":"Pediatrics"},{"issue":"4","key":"zoi260317r21","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.4608","article-title":"Parent-reported errors and adverse events in hospitalized children.","volume":"170","author":"Khan","year":"2016","journal-title":"JAMA Pediatr"},{"issue":"2","key":"zoi260317r22","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.pcl.2015.11.002","article-title":"Patient safety and quality metrics in pediatric hospital medicine.","volume":"63","author":"Kumar","year":"2016","journal-title":"Pediatr Clin North Am"},{"issue":"2","key":"zoi260317r23","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.pcl.2015.12.004","article-title":"Quality care and patient safety in the pediatric emergency department.","volume":"63","author":"Rosen","year":"2016","journal-title":"Pediatr Clin North Am"},{"issue":"2","key":"zoi260317r24","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-3649","article-title":"Principles of pediatric patient safety: reducing harm due to medical care.","volume":"143","author":"Mueller","year":"2019","journal-title":"Pediatrics"},{"issue":"2","key":"zoi260317r25","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-062666","article-title":"Implementing a family-centered rounds intervention using novel mentor-trios.","volume":"153","author":"Khan","year":"2024","journal-title":"Pediatrics"},{"key":"zoi260317r26","doi-asserted-by":"publisher","first-page":"k4764","DOI":"10.1136\/bmj.k4764","article-title":"Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study.","volume":"363","author":"Khan","year":"2018","journal-title":"BMJ"},{"issue":"3","key":"zoi260317r27","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1542\/peds.111.3.617","article-title":"Hospital-reported medical errors in children.","volume":"111","author":"Slonim","year":"2003","journal-title":"Pediatrics"},{"issue":"11","key":"zoi260317r28","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1111\/j.1553-2712.2000.tb00484.x","article-title":"The potential for errors in children with special health care needs.","volume":"7","author":"Sacchetti","year":"2000","journal-title":"Acad Emerg Med"},{"issue":"1","key":"zoi260317r29","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1097\/01.NHH.0000366795.71528.ac","article-title":"OASIS inter-rater reliability and reimbursement: a study of inter-rater reliability of the Outcome and Assessment Information Set (OASIS): its effects on the Home Health Resource Group (HHRG) and reimbursement.","volume":"28","author":"Shew","year":"2010","journal-title":"Home Healthc Nurse"},{"issue":"6","key":"zoi260317r31","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1377\/hlthaff.2018.05531","article-title":"Home health care for children with medical complexity: workforce gaps, policy, and future directions.","volume":"38","author":"Foster","year":"2019","journal-title":"Health Aff (Millwood)"},{"issue":"7","key":"zoi260317r32","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1542\/hpeds.2018-0282","article-title":"Connecting hospital to home: characteristics of and rehospitalization rates in hospitalized children with private-duty nursing.","volume":"9","author":"Foster","year":"2019","journal-title":"Hosp Pediatr"},{"issue":"8","key":"zoi260317r33","doi-asserted-by":"publisher","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"147","author":"von Elm","year":"2007","journal-title":"Ann Intern Med"},{"issue":"4","key":"zoi260317r34","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1001\/jamapediatrics.2016.4812","article-title":"Families as partners in hospital error and adverse event surveillance.","volume":"171","author":"Khan","year":"2017","journal-title":"JAMA Pediatr"},{"issue":"7","key":"zoi260317r35","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1002\/cncr.34651","article-title":"Preventable harm because of outpatient medication errors among children with leukemia and lymphoma: a multisite longitudinal assessment.","volume":"129","author":"Wong","year":"2023","journal-title":"Cancer"},{"issue":"6","key":"zoi260317r36","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1136\/adc.2010.204479","article-title":"Medication errors in the homes of children with chronic conditions.","volume":"96","author":"Walsh","year":"2011","journal-title":"Arch Dis Child"},{"issue":"5","key":"zoi260317r37","doi-asserted-by":"publisher","first-page":"e1405","DOI":"10.1542\/peds.2012-2434","article-title":"Medication errors in the home: a multisite study of children with cancer.","volume":"131","author":"Walsh","year":"2013","journal-title":"Pediatrics"},{"issue":"8","key":"zoi260317r38","doi-asserted-by":"publisher","first-page":"1510","DOI":"10.1016\/j.acap.2022.04.004","article-title":"PediHome: development of a family-reported measure of pediatric home healthcare quality.","volume":"22","author":"Foster","year":"2022","journal-title":"Acad Pediatr"},{"issue":"3","key":"zoi260317r40","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/NHH.0000000000000857","article-title":"Caregiver and provider experiences of home healthcare quality for children with medical complexity.","volume":"38","author":"Foster","year":"2020","journal-title":"Home Healthc Now"},{"issue":"2","key":"zoi260317r41","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/j.pedhc.2020.08.005","article-title":"Improving support for care at home: parental needs and preferences when caring for children with medical complexity.","volume":"36","author":"Foster","year":"2022","journal-title":"J Pediatr Health Care"},{"issue":"10","key":"zoi260317r42","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1177\/00099228221099097","article-title":"Physical and environmental barriers to mobility and participation in children with medical complexity: a qualitative study.","volume":"61","author":"Black","year":"2022","journal-title":"Clin Pediatr (Phila)"},{"issue":"4","key":"zoi260317r43","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1111\/j.1440-1754.1992.tb02667.x","article-title":"Service needs of children with disabilities and their families.","volume":"28","author":"Hollingsworth","year":"1992","journal-title":"J Paediatr Child Health"},{"issue":"10","key":"zoi260317r45","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1513\/AnnalsATS.201612-1002OC","article-title":"Decisions around long-term ventilation for children. perspectives of directors of pediatric home ventilation programs.","volume":"14","author":"Edwards","year":"2017","journal-title":"Ann Am Thorac Soc"},{"issue":"6","key":"zoi260317r46","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1016\/j.acap.2017.04.019","article-title":"Improving the quality of home health care for children with medical complexity.","volume":"17","author":"Nageswaran","year":"2017","journal-title":"Acad Pediatr"},{"issue":"9","key":"zoi260317r47","article-title":"A Qi approach to challenges in home care for families of tracheostomy-dependent children.","volume":"199","author":"Roque","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"issue":"7","key":"zoi260317r48","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1513\/AnnalsATS.201910-780OC","article-title":"\u201cThis is how hard it is\u201d. Family experience of hospital-to-home transition with a tracheostomy.","volume":"17","author":"Amar-Dolan","year":"2020","journal-title":"Ann Am Thorac Soc"},{"issue":"5","key":"zoi260317r50","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-019513","article-title":"Medical device workarounds in providing care for children with medical complexity in the home.","volume":"147","author":"Barton","year":"2021","journal-title":"Pediatrics"},{"issue":"11","key":"zoi260317r51","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1111\/dmcn.13201","article-title":"Children with medical complexity: creating a framework for care based on the International Classification of Functioning, Disability and Health.","volume":"58","author":"Glader","year":"2016","journal-title":"Dev Med Child Neurol"},{"issue":"4","key":"zoi260317r52","first-page":"284","article-title":"A study of pediatric home ventilator management: medical, psychosocial, and financial aspects.","volume":"4","author":"Hazlett","year":"1989","journal-title":"J Pediatr Nurs"},{"issue":"4","key":"zoi260317r53","first-page":"236","article-title":"Managing chronic illness: parents with a ventilator\u2013dependent child.","volume":"4","author":"Scharer","year":"1989","journal-title":"J Pediatr Nurs"},{"issue":"7179","key":"zoi260317r54","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1136\/bmj.318.7179.295","article-title":"Current status of long term ventilation of children in the United Kingdom: questionnaire survey.","volume":"318","author":"Jardine","year":"1999","journal-title":"BMJ"},{"issue":"6","key":"zoi260317r55","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1016\/S0020-7489(01)00069-4","article-title":"Supporting \u2018expert\u2019 parents\u2013professional support and families caring for a child with complex health care needs in the community.","volume":"39","author":"Kirk","year":"2002","journal-title":"Int J Nurs Stud"},{"issue":"9","key":"zoi260317r56","doi-asserted-by":"publisher","first-page":"2034","DOI":"10.1111\/j.1365-2648.2011.05893.x","article-title":"Care closer to home for children and young people who are ill: developing and testing a model of service delivery and organization.","volume":"68","author":"Parker","year":"2012","journal-title":"J Adv Nurs"},{"issue":"2","key":"zoi260317r57","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1155\/2015\/107914","article-title":"How long does it take to initiate a child on long-term invasive ventilation? Results from a Canadian pediatric home ventilation program.","volume":"22","author":"Amin","year":"2015","journal-title":"Can Respir J"},{"issue":"7","key":"zoi260317r58","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1002\/ppul.23040","article-title":"Examining pediatric emergency home ventilation practices in home health nurses: opportunities for improved care.","volume":"50","author":"Kun","year":"2015","journal-title":"Pediatr Pulmonol"},{"issue":"1","key":"zoi260317r59","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1542\/hpeds.2018-0103","article-title":"Encounters from device complications among children with medical complexity.","volume":"9","author":"Nackers","year":"2019","journal-title":"Hosp Pediatr"},{"issue":"2","key":"zoi260317r60","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1093\/intqhc\/mzq003","article-title":"Adverse events experienced by homecare patients: a scoping review of the literature.","volume":"22","author":"Masotti","year":"2010","journal-title":"Int J Qual Health Care"},{"issue":"4","key":"zoi260317r61","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1002\/lary.30250","article-title":"Accidental tracheostomy decannulations in children\u2014a prospective cohort study of inpatients.","volume":"133","author":"Wynings","year":"2023","journal-title":"Laryngoscope"},{"issue":"6","key":"zoi260317r62","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1200\/JCO.2008.18.6072","article-title":"Medication errors among adults and children with cancer in the outpatient setting.","volume":"27","author":"Walsh","year":"2009","journal-title":"J Clin Oncol"},{"issue":"2","key":"zoi260317r63","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1093\/intqhc\/mzw006","article-title":"Types and patterns of safety concerns in home care: client and family caregiver perspectives.","volume":"28","author":"Tong","year":"2016","journal-title":"Int J Qual Health Care"},{"issue":"5","key":"zoi260317r64","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1093\/intqhc\/mzs047","article-title":"Types and patterns of safety concerns in home care: staff perspectives.","volume":"24","author":"Craven","year":"2012","journal-title":"Int J Qual Health Care"},{"key":"zoi260317r12","volume-title":"Developing a Patient-Centered Tool to Improve Medication Device Use and Safety in Homes of Children with Medical Complexity","author":"Shah","year":"2021"},{"key":"zoi260317r39","year":"2016"},{"key":"zoi260317r49","author":"National Research Council Committee on the Role of Human Factors in Home Health Care.","year":"2010"},{"key":"zoi260317r1","unstructured":"Children\u2019s Hospital Association Highlights. Optimizing health care for children with medical complexity. Children\u2019s Hospital Association. 2013. Accessed March 12, 2026. https:\/\/multibriefs.com\/briefs\/nachri\/NACHRI102413.php"},{"key":"zoi260317r2","unstructured":"Vestal C. Improving Medicaid for \u2018medically complex\u2019 kids. Stateline. January 8, 2015. Accessed March 12, 2026. https:\/\/stateline.org\/2015\/01\/08\/improving-medicaid-for-medically-complex-kids\/"},{"key":"zoi260317r8","unstructured":"Berry? J, Agrawal? R, Cohen? E, Kuo? D. Special report: the landscape of medical care for children with medical complexity. Children\u2019s Hospital Association. June 2013. Accessed November 14, 2022. https:\/\/www.columbia.edu\/itc\/hs\/medical\/residency\/peds\/new_compeds_site\/pdfs_new\/PL3%20new%20readings\/Special_Report_The_Landscape_of_Medical_Care_for_Children_with_Medical_Complexity.pdf"},{"key":"zoi260317r30","unstructured":"Home health star ratings. Centers for Medicare & Medicaid Services (CMS). Accessed February 5, 2025. https:\/\/www.cms.gov\/medicare\/quality\/home-health\/home-health-star-ratings"},{"key":"zoi260317r44","unstructured":"Neuss? J. Mothers as Primary Caregivers for Their Technology-Dependent Children at Home: A Qualitative Study. Dissertation. New York University; 2004."}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2848562\/foster_2026_oi_260317_1777310765.95893.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T15:00:26Z","timestamp":1777906826000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2848562"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":64,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.10321","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]}}}