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  1. Effects of providing comprehensive ambulatory services to Children with chronic conditions.

    Article - En anglais


    To document the effects of a comprehensive program of care on the resource utilization and cost of care for children with chronic conditions.


    Descriptive study of 10 715 admissions between 1984 and 1995 with analyses of costs based on charges.

    Comparisons were made with data from a national consortium of academic medical centers and from a national survey of hospitals.

    A 2-week survey of staff was conducted to identify their use of time in the care of these patients.


    Children aged birth through 18 years meeting International Classification of Diseases, Ninth Revision, Clinical Modification criteria for chronic conditions.

    Patients with acute conditions were used as controls.


    A program of expanded care funded since 1989 by a regional insurance company.


    Between 1984 and 1995, mean length of stay for children with chronic conditions decreased from 83.9 to 10.6 days ; mean annual admissions decreased from 2796 to 1622.

    Median hospital inpatient charges, adjusted for cost of living, decreased from $26.1 to $14.6 million.

    A $77.7 million savings occurred for inpatient care, with total expenditures from the insurance program of $3.6 million (a 21 : 1 ratio).

    Almost half the professional activities provided for these children were for services that could not be reimbursed in a fee-forservice model. (...)

    Mots-clés Pascal : Maladie, Chronique, Soin, Ambulatoire, Implantation, Utilisation, Coût, Etude comparative, Enfant, Homme, Adolescent, Assurance régionale

    Mots-clés Pascal anglais : Disease, Chronic, Care, Ambulatory, Implantation, Use, Costs, Comparative study, Child, Human, Adolescent

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0016024

    Code Inist : 002B30A11. Création : 31/05/1999.