Identification of children with medical complexity in administrative datasets in a Canadian context: study protocol

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BMJ open. 2022 Mar 18;12(3):e057843. doi: 10.1136/bmjopen-2021-057843.


INTRODUCTION: Children with medical complexity and their families constitute an important population of interest within the Canadian healthcare system. Although they represent less than 1% of the pediatric population, children with medical complexity require significant care and represent a third of pediatric health expenditure. Opportunities for conducting research to assess disparities in care and appropriate allocation of health resources depend on the ability to accurately identify this heterogeneous group of children. This study aims to better understand the population of children with medical complexity in the Canadian Maritimes, including Nova Scotia (NS), New Brunswick (NB) and Prince Edward Island (PEI). -PE). This objective will be achieved through three objectives: (1) Evaluate the performance of three algorithms for identifying children with medical complexity in the Canadian Maritimes in administrative data; then using the “best fit” algorithm (2) Estimate the prevalence of children with medical complexity in the Canadian Maritimes from 2003 to 2017 and (3) Describe the patterns of healthcare utilization for this cohort of children in the Canadian Maritimes.

METHODS AND ANALYSIS: The research will be conducted in three phases. In Phase 1, a group of experts will jointly develop a benchmark definition of pediatric medical complexity relevant to the population of the Maritimes of Canada. A two-gate validation process will then be conducted using the NS data and the gold standard definition to determine the “best fit” algorithm. In Phase 2, the “best fit” algorithm will be applied to estimate the prevalence of children with complex medical conditions in NS, NB and PEI- E. Finally, Phase 3 will describe patterns of health care utilization in the Canadian Maritimes.

ETHICS AND DISSEMINATION: Ethical approval for this protocol has been granted by the IWK Health Center Institutional Research Ethics Board (REB # 1026245). A waiver of consent was approved. This study will use an integrated knowledge translation approach, where end users are involved in every stage of the project, which could increase uptake of the research into policy and practice. The results of this research study will be submitted for publication and dissemination through presentations at the conference and to our end users.

PMID:35304399 | DOI:10.1136/bmjopen-2021-057843

Sharon D. Cole