ArticleThe Journal of pediatrics2019
Post-Trial Sustainability and Scalability of the Benefits of a Medical Home for High-Risk Children with Medical Complexity.
Article in The Journal of pediatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed.
- Unexpected results of a randomized quality improvement program for children with severe asthma.The Journal of asthma : official journal of the Association for the Care of Asthma · 2021Trial
- Hospital Consultation From Outpatient Clinicians for Medically Complex Children: A Randomized Clinical Trial.JAMA pediatrics · 2021Trial
- Article
- Randomized Controlled Trial of Enteral Vitamin D Supplementation (ViDES) in Infants <28 Weeks Gestational Age or <1000 Grams Birth Weight: Study Protocol.Research square · 2024Article
- Financing Policy Considerations From Texas to Optimize Care for Children With Medical Complexity.Pediatrics · 2024Article
- Implementation and Evaluation of a Wraparound Virtual Care Program for Children with Medical Complexity.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2023Article
- Intervention research to improve care and outcomes for children with medical complexity and their families.Current problems in pediatric and adolescent health care · 2021Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectiveTo assess the sustainability of the benefits relative to usual care of a medical home providing comprehensive care for high-risk children with medical complexity (≥2 hospitalizations or ≥1 pediatric intensive care unit [PICU] admission in the year before enrollment) after we made comprehensive care our standard practice and expanded the program. STUDY
designWe conducted pre-post comparisons of the rate of children with serious illness (death, PICU admission, or >7-day hospitalization) and health-system costs observed after program expansion (March 2014-June 2015) to those during the clinical trial (March 2011-August 2013) for each of the trial's treatment groups (usual care, n = 96, and comprehensive care, n = 105; primary analyses), and among all children given comprehensive care (n
resultsIn intent-to-treat analyses, rates of children with serious illness and costs were reduced or unchanged post-trial vs trial for the trial's usual care group (rate ratio [RR], 0.36; 95% CI, 0.20-0.64; cost ratio [CR], 0.68; 95% CI, 0.28-1.68), the trial's comprehensive care group (RR, 0.74; 95% CI, 0.39-1.41; CR, 0.67; 95% CI, 0.51-0.89), and among all children given comprehensive care (RR, 0.97; 95% CI, 0.61-1.52; CR, 0.75; 95% CI, 0.61-0.93). Conservative stepped-wedge analyses identified overall benefits with comprehensive care across both study periods (RR, 0.46; 95% CI, 0.30-0.72; CR, 0.64; 95% CI, 0.43-0.99).
conclusionsMajor benefits of comprehensive care did not diminish with post-trial program expansion.
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