Ways to Identify Children with Medical Complexity and the Importance of Why

Comparison of 4 examples of diagnosis classification systems that have been used to identify the health problems in children with medical complexity: (1) Complex chronic conditions (CCCs), an open-source set of childhood conditions that are strongly associated with mortality, morbidity, functional limitations, high health resource utilization, and use of a complex care clinical program; (2) Clinical risk groups (CRGs), a proprietary system of hierarchical pediatric diagnosis groups ranging from healthy children without a chronic condition to unhealthy children with a catastrophic chronic condition that is associated with high morbidity and mortality; (3) Chronic condition indicators (CCIs), developed by the Agency for Healthcare Research and Quality, an open source diagnosis classification system that dichotomizes ∼14 000 ICD9 and ∼68 000 ICD10 diagnosis codes into chronic and non chronic conditions; and Patient medical complexity algorithm (PMCA), developed by Seattle Children’s Hospital, an open source, pediatric-specific, diagnosis classification system that uses ICD9 codes to group children into 1 of 3 categories: complex, chronic disease; noncomplex, chronic disease; and nonchronic disease.

Berry 2015 (J. Pediatrics) | PubMed 26028285 | Author Search

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