{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:09:36Z","timestamp":1792091376881,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,1,30]],"date-time":"2022-01-30T00:00:00Z","timestamp":1643500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The aim of this work is to explore the unintended consequences of pandemic public health measures on health care service usage by children with medical complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medical complexity is characterized by the presence of complex, chronic conditions requiring specialized care, substantial health needs, functional dependence and\/or limitations, and frequent health care usage. Children with medical complexity are among the highest users of paediatric health care services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A web\u2010based, cross\u2010sectional survey was conducted in British Columbia, Canada, between August and September 2020. Inclusion criteria were (a) parent\/guardian of at least one child (age 0 to 18\u2009years, inclusive) with medical complexity and (b) residence in British Columbia. A convenience sample of 156 parents completed the survey. Data were analysed using a series of descriptive analyses (frequencies, cross\u2010tabulations) and inferential analyses (binary logistic regressions).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Respondents provided information for 188 children with medical complexity. Access to allied health therapies (physio, occupational, and speech and language) and medical specialists drastically declined in the initial months of the pandemic, with a shift from in\u2010person to virtual platforms for these aspects of care. Regression modelling indicated that age and family structure influenced decisions to use in\u2010patient hospital services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Public health measures implemented in the initial months of the pandemic decreased access to health care services for children with medical complexity. The long\u2010term ramifications of these measures are unknown. Family structure was found to influence decisions to avoid accessing Emergency Department care. Given the volume of services used by these children, paediatric hospital leaders need to take their unique needs into consideration in disaster planning to ensure minimal disruptions in care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cch.12968","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T03:07:38Z","timestamp":1642561658000},"page":"970-978","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["The unintended consequences of COVID\u201019 public health measures on health care for children with medical complexity"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3915-6881","authenticated-orcid":false,"given":"Jennifer","family":"Baumbusch","sequence":"first","affiliation":[{"name":"School of Nursing University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer E. V.","family":"Lloyd","sequence":"additional","affiliation":[{"name":"School of Nursing University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawna R.","family":"Lamden\u2010Bennett","sequence":"additional","affiliation":[{"name":"School of Nursing University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Ou","sequence":"additional","affiliation":[{"name":"School of Nursing University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1284D"},{"key":"e_1_2_11_3_1","unstructured":"BC Centre for Disease Control.British Columbia (BC) COVID\u201019 Situation Report Week 42: October 11\u2013October 17 2020.2020:1\u201012. Accessed March 8 2021.http:\/\/www.bccdc.ca\/Health-Info-Site\/Documents\/COVID_sitrep\/BC_COVID-19_Situation_Report_Jan_15_2021.pdf"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2016-0179"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2010.06.003"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/01942638.2020.1825032"},{"key":"e_1_2_11_7_1","unstructured":"Canadian Foundation for Healthcare Improvement.Provincial Governments Guidence for Family Presence and Visitor Policies.2021. Accessed March 8 2021.www.cfhi-fcass.ca\/docs\/default-source\/itr\/tools-and-resources\/federal-provincial-territorial-guidance-on-family-presence-and-visitations-scan"},{"key":"e_1_2_11_8_1","unstructured":"Canadian Institute for Health Information.Children and Youth with Medical Complexity in Canada.2020:1\u201330. Accessed March 18 2021.https:\/\/www.cihi.ca\/sites\/default\/files\/document\/children-youth-with-medical-complexity-report-en.pdf"},{"key":"e_1_2_11_9_1","unstructured":"Canadian Institute for Health Information.COVID\u201019 Intervention Timeline in Canada.2021. Accessed February 18 2021.https:\/\/www.cihi.ca\/en\/covid-19-intervention-timeline-in-canada"},{"key":"e_1_2_11_10_1","unstructured":"CAPHC.CAPHC guideline for the management of medically complex children & youth through the continuum of care.2018:1\u201339. Accessed March 8 2021.https:\/\/www.macpeds.com\/documents\/CAPHC%20National%20Complex%20Care%20Guideline%202018_final.pdf"},{"key":"e_1_2_11_11_1","unstructured":"CBC News. (n.d.).The COVID\u201019 pandemic: A timeline of key events across British Columbia.https:\/\/www.cbc.ca\/news\/canada\/british-columbia\/covid-19-bc-timeline-1.5520943"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0175"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1284E"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/18.10.518"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.14574\/ojrnhc.v15i2.364"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-009-0477-y"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9050528"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1362361318815237"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMpv2101339"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2020.1862925"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-3266"},{"key":"e_1_2_11_22_1","unstructured":"Statistics Canada. (n.d.).Population centre (POPCTR). Accessed December 3 2021.https:\/\/www12.statcan.gc.ca\/census-recensement\/2016\/ref\/dict\/geo049a-eng.cfm"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2020-005772"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-0973"}],"container-title":["Child: Care, Health and Development"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cch.12968","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cch.12968","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cch.12968","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T06:33:12Z","timestamp":1692685992000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cch.12968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,30]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1111\/cch.12968"],"URL":"https:\/\/doi.org\/10.1111\/cch.12968","archive":["Portico"],"relation":{},"ISSN":["0305-1862","1365-2214"],"issn-type":[{"value":"0305-1862","type":"print"},{"value":"1365-2214","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,30]]},"assertion":[{"value":"2021-07-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}