La dimissione protetta del bambino clinicamente complesso

Author:

Lugli Licia1,Garetti Elisabetta1,Rossi Katia1,Torcetta Francesco1,Cuomo Giovanna1,Lucaccioni Laura2,Pugliese Marisa1,Bertoncelli Natascia1,Rossi Cecilia1,Riva Marika3,Iughetti Lorenzo3,Ferrari Fabrizio1,Berardi Alberto1

Affiliation:

1. UOC di Terapia Intensiva Neonatale, Azienda Ospedaliero-Universitaria Policlinico di Modena

2. UOC di Pediatria, Azienda Ospedaliero-Universitaria Policlinico di M

3. UOC di Pediatria, Azienda Ospedaliero-Universitaria Policlinico di Modena

Abstract

Background - In the last few years care for children with severe chronic conditions is a topic of increasing interest. Children with chronic illness often require a high complexity of care and a high level of coordination among health services. Objective - The primary aim of this study is the assessment of children with chronic disease and high complexity of care (children with medical complexity), discharged from the Neonatal Intensive Care Unit (NICU) of Modena University-Hospital. The secondary aim is to assess the outcome of these patients. Methods - Patients with chronic diseases and high complexity of care (children with medical complexity), aged 0-6 months, and admitted to the NICU of Modena in the years 2009-2019 were recruited. Results - 59 subjects were included, of which 15 (25.4%) were born preterm, 11 (18.6%) suffered from hypoxic-ischemic encephalopathy, 33 (56%) had genetic diseases or malformations. All patients were discharged home, except for one patient who was discharged to hospice. The average hospital length of stay was 116.0 ± 63.4 days. Follow-up visits showed that 25 cases (42.4%) remained unchanged, 18 (30.5%) improved and 16 (27.1%) died. Conclusion - This study allows an assessment of patients with early diagnosis of chronic disease with high complexity of care, showing that some of these patients could be eligible for palliative care. The management of children with medical complexity requires diagnostic-therapeutic programmes that focus on them and their families and connect hospital and territorial health services.

Publisher

Medico e Bambino

Subject

Pediatrics, Perinatology and Child Health

Reference21 articles.

1. Definitions and Measurement of Chronic Health Conditions in Childhood

2. Identifying Children with Lifelong Chronic Conditions for Care Coordination by Using Hospital Discharge Data

3. Guidelines for home care of infants, children, and adolescents with chronic disease;American Academy of Pediatrics;Pediatrics,1995

4. Hospital discharge of the high-risk neonate;American Academy of Pediatrics;Pediatrics,2008

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