pediatrics
Children with Chronic Health Conditions
Care coordination
Without coordination of services, care is crisis-oriented. Some services will be duplicated, whereas others will be neglected. Care coordination requires knowledge of the children’s condition, their family and support systems, and the community in which they function. All professionals who care for children with chronic health conditions must ensure that someone is coordinating care. Sometimes the coordinator can be the child’s parent. However, the systems that must be negotiated are often so complex that even the most capable parents need assistance. Other possible coordinators include the primary care physician, the subspecialty program staff, the community health nurse, and staff of the 3rd-party payer. Regardless of who coordinates services, families and children must be partners in the process. In general, children from low-income families who have chronic conditions fare worse than others, in part because of lack of access to health care and care coordination services. Primary care practices may coordinate care services for children with medical complexity, a concept known as the patient-centered medical home ( General references ). Some children with terminal illness benefit from 