{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:06:09Z","timestamp":1791486369496,"version":"4.3.4"},"reference-count":50,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Although many children with medical complexity (CMC) use home health care (HHC), little is known about all pediatric HHC utilizers. Our objective was to assess characteristics of pediatric HHC recipients, providers, and payments.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We conducted a retrospective analysis of 5 209 525 children age 0-to-17 years enrolled Medicaid in the 2016 IBM Watson MarketScan Medicaid Database. HHC utilizers had \u2265 1 HHC claim. Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) codes were reviewed to codify provider types when possible: registered nurse (RN), licensed practical nurse (LPN), home health aide (HHA), certified nursing assistant (CNA), or companion\/personal attendant. Enrollee clinical characteristics, HHC provider type, and payments were assessed. Chronic conditions were evaluated with Agency for Healthcare Research and Quality\u2019s Chronic Condition Indicators and Feudtner\u2019s Complex Chronic Conditions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Of the 0.8% of children who used HHC, 43.8% were age &amp;lt;1 year, 25% had no chronic condition, 38.6% had a noncomplex chronic condition, 21.5% had a complex chronic condition without technology assistance, and 15.5% had technology assistance (eg, tracheostomy). HHC for children with technology assistance accounted for 72.6% of all HHC spending. Forty-five percent of HHC utilizers received RN\/LPN-level care, 7.9% companion\/personal attendant care, 5.9% HHA\/CNA-level care, and 36% received care from an unspecified provider. For children with technology assistance, the majority (77.2%) received RN\/LPN care, 17.5% companion\/personal assistant care, and 13.8% HHA\/CNA care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Children using HHC are a heterogeneous population who receive it from a variety of providers. Future investigations should explore the role of nonnurse caregivers, particularly with CMC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2021-050534","type":"journal-article","created":{"date-parts":[[2022,1,14]],"date-time":"2022-01-14T08:12:05Z","timestamp":1642147925000},"source":"Crossref","is-referenced-by-count":19,"title":["Home Health Care Utilization in Children With Medicaid"],"prefix":"10.1542","volume":"149","author":[{"given":"Sarah A.","family":"Sobotka","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Section of Developmental and Behavioral Pediatrics, University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Hall","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr, Children\u2019s Hospital at Vanderbilt, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cary","family":"Thurm","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Association, Lenexa, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Gay","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr, Children\u2019s Hospital at Vanderbilt, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay G.","family":"Berry","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of General Pediatrics, Complex Care Service, Boston Children\u2019s Hospital, Department of Pediatrics, Harvard Medical School, Boston, 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Safety & Oversight Group \u2013 Centers for Medicare & Medicaid Services. Home Health Agencies State Operations Manual Appendix B Interpretive Guidance Frequently Asked Questions (FAQ). Available at: https:\/\/www.cms.gov\/Medicare\/Provider-Enrollment- and-Certification\/SurveyCertification GenInfo\/Administrative-Information- Memos-to-the-States-and-Regions-Items\/Admin-Info-Letter-19-07. Published 2019. Updated January 23, 2019. Accessed January 15, 2021"},{"key":"2022020117403631700_B50","unstructured":"Centers for Disease Control and Prevention. Prevention CfDCa\n          . Home Health Care. 2016. Available at: https:\/\/www.cdc.gov\/nchs\/fastats\/home-health-care.htm. 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