Hospital-Based Comprehensive Care Programs for Children With Special Health Care Needs

摘要: Objective To examine the effectiveness of hospital-based comprehensive care programs in improving quality for children with special health needs. Data Sources A systematic review was conducted using Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Sociological Abstracts SocioFile, and Web Science. Study Selection Evaluations categorical (those single disease) noncategorical groups needs were included. Selected articles reviewed independently by 2 raters. Extraction Models focused on based at least partially a hospital setting. The main outcome measures proportions studies demonstrating improvement Institute Medicine's quality-of-care domains (effectiveness care, efficiency patient or family centeredness, safety, timeliness equity care). Synthesis Thirty-three unique included, 13 (39%) which randomized controlled trials. Improved outcomes most commonly reported (64% [49 76 outcomes]), (60% [57 95 centeredness (53% [10 19 outcomes). Outcomes less evaluated safety (9% [3 33 programs]), (6% [2 (0%). Randomized trials occurred more frequently evaluating vs disease populations (11 17 [65%] 16 [17%], P  = .008). Conclusions Although positive, evidence supporting is restricted primarily to nonexperimental diseases limited inadequate measures. Additional high-quality appropriate comparative broad necessary justify continued development growth