![]() Risk and protective factors were explored using an ecological perspective, with factors in the domains of the person, family, school, community, and society considered ( Hawkins, Catalano, & Miller, 1992). According to this model, an outcome is more likely when some features of a person or environment are present (risk factors) and less likely in the presence of other features (protective factors) ( Nagy & Fawcett, 2011). Since the purpose of this study was to explore factors associated with hospital admissions and ED visits in children with CCC, the risk and protective factors model was chosen as the theoretical framework to guide the investigation. The purpose of this exploratory study was to assess the feasibility of the data collection and analysis plan and to investigate the following research questions: Which of the demographic and clinical variables collected in a sample of children with CCC influence hospital admissions and emergency department (ED) visits? Which of these variables should be prospectively examined for their potential to predict hospital admissions and ED visits? Investigation into the factors contributing to health care utilization among this population is necessary because of the high health care utilization and costs for children with CCC. Buescher, Whitmire, Brunssen, and Kluttz-Hile (2006) estimated the annual Medicaid claims for a child with CCC and technological dependence to be approximately $69,906 per year compared with an average Medicaid claims cost of $3,159 per year for a child without a CCC solely receiving well services. As a result of the high health care utilization rates, cost burdens of care for this population are disproportionately high and the increasing numbers of hospital admissions in children can be attributed to children with CCC ( Burns et al., 2010 Simon et al., 2010). These children have increasingly high pediatric inpatient days and hospital charges ( Simon et al., 2010), high rates of pediatric ED visits, and high rates of hospital admissions resulting from pediatric ED visits ( O’Mahony et al., 2013). 4% of children in general ( Kuo, Cohen, Agrawal, Berry, & Casey, 2011), children with CCC have a high impact on health care.Īccording to Feudtner, Christakis, and Connell (2000) children with CCC have a health condition that is expected to last at least 12 months, affecting one or more body systems substantially enough that specialty care and hospitalization are necessary. Children with complex chronic conditions (CCC) are a subset of CSHCN with more complex health problems and greater health care needs although their prevalence is estimated at 3.2% of CSHCN and. Children with special health care needs (CSHCN) are those children who have, or are at risk for, health problems and require greater numbers of health services than children in general ( McPherson et al., 1998). A substantial and growing portion of the pediatric population has long-term health conditions.
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