{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:37:10Z","timestamp":1793306230378,"version":"4.5.0"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,7,1]]},"abstract":"<jats:p>OBJECTIVES. Objectives included testing use of the care-coordination measurement tool in pediatric primary care practices; describing care-coordination activities for children and youth that occur in primary care practices; assessing the relationship of care-coordination activities in the medical home with outcomes related to resource use; and measuring the direct personnel costs of care-coordination activities.<\/jats:p>\n               <jats:p>METHODS. Six general pediatric practices were selected, representing a diverse range of sizes, locations, patient demographics, and care-coordination activity model types. The care-coordination measurement tool was used over a period of 8 months in 2003 to record all of the nonreimbursable care-coordination activity encounters performed by any office-based personnel. The tool enabled recording of activities, resources-use outcomes, and time. Cost of personnel performing care-coordination activities was derived by extrapolation from the time spent.<\/jats:p>\n               <jats:p>RESULTS. Care-coordination activity services were used by patients of all complexity levels. Children and youth with special health care needs with acute-onset, family-based psychosocial problems experienced 14% of the care-coordination activity encounters and used 21% of the care-coordination activities minutes. Children and youth without special health care needs, without complicating family psychosocial problems, received 50% of the encounters and used 36% of the care-coordination activity minutes. The average cost per care-coordination activity encounter varied from $4.39 to $12.86, with an overall mean of $7.78. A principal cost driver seemed to be the percentage of care-coordination activities performed by physicians. Office-based nurses prevented a large majority of emergency department visits and episodic office visits.<\/jats:p>\n               <jats:p>CONCLUSIONS. Care-coordination activity was assessed at the practice level, and the care-coordination measurement tool was used successfully during the operations of typical, pediatric, primary care settings. The presence of acute, family-based social stressors was a significant driver of need for care-coordination activities. A high proportion of dependence on care-coordination performed by physicians led to increased costs. Office-based nurses providing care coordination were responsible for a significant number of episodes of avoidance of higher cost use outcomes.<\/jats:p>","DOI":"10.1542\/peds.2007-2254","type":"journal-article","created":{"date-parts":[[2008,7,1]],"date-time":"2008-07-01T13:29:15Z","timestamp":1214918955000},"page":"e209-e216","source":"Crossref","is-referenced-by-count":149,"title":["Care Coordination for Children and Youth With Special Health Care Needs: A Descriptive, Multisite Study of Activities, Personnel Costs, and Outcomes"],"prefix":"10.1542","volume":"122","author":[{"given":"Richard C.","family":"Antonelli","sequence":"first","affiliation":[{"name":"Connecticut Children's Medical Center and Division of Academic General Pediatrics, University of Connecticut School of Medicine, Hartford, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Stille","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna M.","family":"Antonelli","sequence":"additional","affiliation":[{"name":"Division of Planning and Performance Measurement, Lahey Clinic, Burlington, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2008,7,1]]},"reference":[{"key":"2021120905573788600_R1","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Council on Children With Disabilities. Care coordination in the medical home: integrating health and related systems of care for children with special health care needs. Pediatrics.2005;116(5):1238\u20131244","DOI":"10.1542\/peds.2005-2070"},{"key":"2021120905573788600_R2","unstructured":"Committee on Quality of Health Care in America, Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press;2001"},{"key":"2021120905573788600_R3","unstructured":"US Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2nd ed. Washington, DC: US Department of Health and Human Services;2000"},{"key":"2021120905573788600_R4","doi-asserted-by":"crossref","unstructured":"Stille CJ, Antonelli RC. Coordination of care for children with special health care needs. Curr Opin Pediatr.2004;16(6):700\u2013705","DOI":"10.1097\/01.mop.0000144442.68016.92"},{"key":"2021120905573788600_R5","doi-asserted-by":"crossref","unstructured":"Kisker CT, Fethke CC, Tannous R. Shared management of children with cancer. Arch Pediatr Adolesc Med.1997;151(10):1008\u20131013","DOI":"10.1001\/archpedi.1997.02170470042008"},{"key":"2021120905573788600_R6","doi-asserted-by":"crossref","unstructured":"Liptak GS, Burns CM, Davidson PW, McAnarney E. Effects of providing comprehensive ambulatory services to children with chronic conditions. Arch Pediatr Adolesc Med.1998;152(10):1003\u20131008","DOI":"10.1001\/archpedi.152.10.1003"},{"key":"2021120905573788600_R7","doi-asserted-by":"crossref","unstructured":"Palfrey JS, Sofis LA, Davidson EJ, et al. The Pediatric Alliance for Coordinated Care: evaluation of a medical home model. Pediatrics.2004;113(5 suppl):1507\u20131516","DOI":"10.1542\/peds.113.S4.1507"},{"key":"2021120905573788600_R8","doi-asserted-by":"crossref","unstructured":"Gupta VB, O'Connor KG, Quezada-Gomez C. Care coordination services in pediatric practices. Pediatrics.2004;113(5 suppl):1517\u20131521","DOI":"10.1542\/peds.113.S4.1517"},{"key":"2021120905573788600_R9","unstructured":"Wells N, Krauss MW, Anderson B, et al. What do families say about health care for children with special health care needs? Your Voice Counts!! The Family Partners Project Report to Families. Unpublished manuscript. Boston, MA: Family Voices at the Federation for Children with Special Health Care Needs,2000"},{"key":"2021120905573788600_R10","unstructured":"Family Voices at the Federation for Children With Special Health Care Needs. Your Voice Counts!! The Family Partners Project Report to Families. Boston, MA: Family Voices at the Federation for Children With Special Health Care Needs;2000"},{"key":"2021120905573788600_R11","doi-asserted-by":"crossref","unstructured":"Stille CJ, Jerant A, Bell D, Meltzer D, Elmore JG. Coordinating care across diseases, settings, and clinicians: a key role for the generalist in practice. Ann Intern Med.2005;142(8):700\u2013708","DOI":"10.7326\/0003-4819-142-8-200504190-00038"},{"key":"2021120905573788600_R12","doi-asserted-by":"crossref","unstructured":"Antonelli RC, Antonelli DM. Providing a medical home: the cost of care coordination services in a community-based, general pediatric practice. Pediatrics.2004;113(5 suppl):1522\u20131528","DOI":"10.1542\/peds.113.S4.1522"},{"key":"2021120905573788600_R13","doi-asserted-by":"crossref","unstructured":"McPherson M, Arango P, Fox H, et al. A new definition of children with special health care needs. Pediatrics.1998;102(1 pt 1):137\u2013140","DOI":"10.1542\/peds.102.1.137"},{"key":"2021120905573788600_R14","unstructured":"US Bureau of Labor Statistics. Occupational employment statistics. Available at: http:\/\/data.bls.gov\/oes\/search.jsp. Accessed May 10,2003"},{"key":"2021120905573788600_R15","unstructured":"US Bureau of Labor Statistics. 29-0000 Healthcare Practitioners and Technical Occupations. Available at: www.bls.gov\/oes\/2003\/May\/oes_stru.htm. Accessed October 15,2003"},{"key":"2021120905573788600_R16","unstructured":"American Medical Association. Current Procedural Terminology, 2007. Chicago, IL: American Medical Association;2007"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/122\/1\/e209\/1068794\/zpe0070800e209.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/122\/1\/e209\/1068794\/zpe0070800e209.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T23:57:34Z","timestamp":1639094254000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/122\/1\/e209\/73026\/Care-Coordination-for-Children-and-Youth-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7,1]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2008,7,1]]},"published-print":{"date-parts":[[2008,7,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2007-2254","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,7,1]]}}}