Integrated Care Models and Child Health: A Meta-analysis

Wolfe, Ingrid, Satherley, Rose-Marie, Scotney, Elizabeth, Newham, James and Lingam, Raghu (2020) Integrated Care Models and Child Health: A Meta-analysis. Pediatrics, 145 (1). e20183747. ISSN 0031-4005

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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.

Item Type: Article
Subjects: B100 Anatomy, Physiology and Pathology
B700 Nursing
B900 Others in Subjects allied to Medicine
Department: Faculties > Health and Life Sciences > Psychology
Depositing User: Rachel Branson
Date Deposited: 18 Feb 2020 14:33
Last Modified: 20 Feb 2020 10:13

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