Integrated Care Models and Child Health: A Meta-analysis

Ingrid Wolfe, Rose Marie Satherley, Elizabeth Scotney, James Newham, Raghu Lingam

Research output: Contribution to journalReview articlepeer-review

4 Citations (Scopus)

Abstract

CONTEXT: Integrated care models may improve health care for children and young people (CYP) with ongoing conditions. 

OBJECTIVE: To assess the effects of integrated care on child health, health service use, health care quality, school absenteeism, and costs for CYP with ongoing conditions. 

DATA SOURCES: Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library databases (1996-2018). 

STUDY SELECTION: Inclusion criteria consisted of (1) randomized controlled trials, (2) evaluating an integrated care intervention, (3) for CYP (0-18 years) with an ongoing health condition, and (4) including at least 1 health-related outcome. 

DATA EXTRACTION: Descriptive data were synthesized. Data for quality of life (QoL) and emergency department (ED) visits allowed meta-analyses to explore the effects of integrated care compared to usual care. RESULTS: Twenty-three trials were identified, describing 18 interventions. Compared with usual care, integrated care reported greater cost savings (3/4 studies). Meta-analyses found that integrated care improved QoL over usual care (standard mean difference = 0.24; 95% confidence interval = 0.03-0.44; P = .02), but no significant difference was found between groups for ED visits (odds ratio = 0.88; 95% confidence interval = 0.57-1.37; P = .57). 

LIMITATIONS: Included studies had variable quality of intervention, trial design, and reporting. Randomized controlled trials only were included, but valuable data from other study designs may exist. 

CONCLUSIONS: Integrated care for CYP with ongoing conditions may deliver improved QoL and cost savings. The effects of integrated care on outcomes including ED visits is unclear.

Original languageEnglish
Article numbere20183747
Number of pages14
JournalPediatrics
Volume145
Issue number1
Early online date30 Dec 2019
DOIs
Publication statusPublished - 1 Jan 2020
Externally publishedYes

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