Integrated children's clinic care (ICCC) versus a self-directed care pathway for children with a chronic health condition: A multi-centre randomised controlled trial study protocol

Thuy Thanh Frakking, John Waugh, Hsien Jin Teoh, Doug Shelton, Susan Moloney, Donna Ward, Michael David, Matthew Barber, Hannah Carter, Sharon Mickan, Kelly Weir

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Background: Children with chronic health conditions have better health-related outcomes when their care is managed in a personalised and coordinated way. However, increased demand on Australian ambulatory care hospital services has led to longer waitlist times to access specialists and appropriate intervention services; placing vulnerable children at increased risk of poorer short-term (e.g. social difficulties) and long-term (e.g. convictions) health and social outcomes. Traditional approaches to increasing frequency and service of delivery are expensive and can have minimal impact on caregiver burden. A community based service-integration approach, rather than self-directed care is proposed as increased service linkages are more likely to occur and improve the health outcomes of children with a chronic health condition. Methods: An open, unblinded, multi-centre randomised controlled trial in two Australian public hospitals. 112 children (0-16 years) fulfilling the inclusion criteria will be randomised to one of two clinical pathways for management of their chronic health condition: (1) integrated children's care clinic (ICCC) or (2) self-directed care pathway. All children and caregivers will be interviewed at 1 week, and 3, 6 and 12 month time intervals. Primary outcome measures include the Pediatric Quality of Life (PedQOL) questionnaire, Subjective Units of Distress Scale, Child Behaviour Checklist (CBCL) and Rotter's Locus of Control Scale. Secondary outcome measures include the total number of medical appointments, school days missed and quantity of services accessed. Our main objectives are to determine if the ICCC results in better health and economics outcomes compared to the self-directed care pathway. Discussion: The success of a health systems approach needs to be balanced against clinical, mortality and cost-effectiveness data for long-term sustainability within a publicly funded health system. A clinical pathway that is sustainable, cost-effective, provides efficient evidence-based care and improves the quality of life outcomes for children with chronic health conditions has the potential to reduce waitlist times, improve access to health services, increase consumer satisfaction; and prevent costs associated with poorly managed chronic health conditions into adulthood. This study will be the first to provide clinical and health economics data on an integrated care pathway for the management of chronic health conditions in children. On a broader scale, results from this study will help guide care coordination frameworks for children with chronic health conditions; particularly with the introduction and implementation of a National Disability Insurance Scheme (NDIS) across Australia.


The study is funded by an experienced researcher grant from Allied Health Professions of Queensland (AHPOQ) – Health Practitioner Research Scheme (Government body). AHPOQ’s role in this study is purely related to funding and had no role in the study design.

Original languageEnglish
Article number72
JournalBMC Pediatrics
Volume18
Issue number1
DOIs
Publication statusPublished - 19 Feb 2018
Externally publishedYes

Fingerprint

Self Care
Clinical Protocols
Child Care
Randomized Controlled Trials
Health
Critical Pathways
Caregivers
Disability Insurance
Economics
Quality of Life
Outcome Assessment (Health Care)
Costs and Cost Analysis
Queensland
Internal-External Control
Organized Financing
Social Welfare
Public Hospitals
Child Behavior
Managed Care Programs
Ambulatory Care

Cite this

Frakking, Thuy Thanh ; Waugh, John ; Teoh, Hsien Jin ; Shelton, Doug ; Moloney, Susan ; Ward, Donna ; David, Michael ; Barber, Matthew ; Carter, Hannah ; Mickan, Sharon ; Weir, Kelly. / Integrated children's clinic care (ICCC) versus a self-directed care pathway for children with a chronic health condition : A multi-centre randomised controlled trial study protocol. In: BMC Pediatrics. 2018 ; Vol. 18, No. 1.
@article{d3c594e452bc4b9b9b681569c6e84f14,
title = "Integrated children's clinic care (ICCC) versus a self-directed care pathway for children with a chronic health condition: A multi-centre randomised controlled trial study protocol",
abstract = "Background: Children with chronic health conditions have better health-related outcomes when their care is managed in a personalised and coordinated way. However, increased demand on Australian ambulatory care hospital services has led to longer waitlist times to access specialists and appropriate intervention services; placing vulnerable children at increased risk of poorer short-term (e.g. social difficulties) and long-term (e.g. convictions) health and social outcomes. Traditional approaches to increasing frequency and service of delivery are expensive and can have minimal impact on caregiver burden. A community based service-integration approach, rather than self-directed care is proposed as increased service linkages are more likely to occur and improve the health outcomes of children with a chronic health condition. Methods: An open, unblinded, multi-centre randomised controlled trial in two Australian public hospitals. 112 children (0-16 years) fulfilling the inclusion criteria will be randomised to one of two clinical pathways for management of their chronic health condition: (1) integrated children's care clinic (ICCC) or (2) self-directed care pathway. All children and caregivers will be interviewed at 1 week, and 3, 6 and 12 month time intervals. Primary outcome measures include the Pediatric Quality of Life (PedQOL) questionnaire, Subjective Units of Distress Scale, Child Behaviour Checklist (CBCL) and Rotter's Locus of Control Scale. Secondary outcome measures include the total number of medical appointments, school days missed and quantity of services accessed. Our main objectives are to determine if the ICCC results in better health and economics outcomes compared to the self-directed care pathway. Discussion: The success of a health systems approach needs to be balanced against clinical, mortality and cost-effectiveness data for long-term sustainability within a publicly funded health system. A clinical pathway that is sustainable, cost-effective, provides efficient evidence-based care and improves the quality of life outcomes for children with chronic health conditions has the potential to reduce waitlist times, improve access to health services, increase consumer satisfaction; and prevent costs associated with poorly managed chronic health conditions into adulthood. This study will be the first to provide clinical and health economics data on an integrated care pathway for the management of chronic health conditions in children. On a broader scale, results from this study will help guide care coordination frameworks for children with chronic health conditions; particularly with the introduction and implementation of a National Disability Insurance Scheme (NDIS) across Australia.The study is funded by an experienced researcher grant from Allied Health Professions of Queensland (AHPOQ) – Health Practitioner Research Scheme (Government body). AHPOQ’s role in this study is purely related to funding and had no role in the study design.",
author = "Frakking, {Thuy Thanh} and John Waugh and Teoh, {Hsien Jin} and Doug Shelton and Susan Moloney and Donna Ward and Michael David and Matthew Barber and Hannah Carter and Sharon Mickan and Kelly Weir",
year = "2018",
month = "2",
day = "19",
doi = "10.1186/s12887-018-1034-x",
language = "English",
volume = "18",
journal = "BMC Pediatrics",
issn = "1471-2431",
publisher = "BioMed Central",
number = "1",

}

Integrated children's clinic care (ICCC) versus a self-directed care pathway for children with a chronic health condition : A multi-centre randomised controlled trial study protocol. / Frakking, Thuy Thanh; Waugh, John; Teoh, Hsien Jin; Shelton, Doug; Moloney, Susan; Ward, Donna; David, Michael; Barber, Matthew; Carter, Hannah; Mickan, Sharon; Weir, Kelly.

In: BMC Pediatrics, Vol. 18, No. 1, 72, 19.02.2018.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Integrated children's clinic care (ICCC) versus a self-directed care pathway for children with a chronic health condition

T2 - A multi-centre randomised controlled trial study protocol

AU - Frakking, Thuy Thanh

AU - Waugh, John

AU - Teoh, Hsien Jin

AU - Shelton, Doug

AU - Moloney, Susan

AU - Ward, Donna

AU - David, Michael

AU - Barber, Matthew

AU - Carter, Hannah

AU - Mickan, Sharon

AU - Weir, Kelly

PY - 2018/2/19

Y1 - 2018/2/19

N2 - Background: Children with chronic health conditions have better health-related outcomes when their care is managed in a personalised and coordinated way. However, increased demand on Australian ambulatory care hospital services has led to longer waitlist times to access specialists and appropriate intervention services; placing vulnerable children at increased risk of poorer short-term (e.g. social difficulties) and long-term (e.g. convictions) health and social outcomes. Traditional approaches to increasing frequency and service of delivery are expensive and can have minimal impact on caregiver burden. A community based service-integration approach, rather than self-directed care is proposed as increased service linkages are more likely to occur and improve the health outcomes of children with a chronic health condition. Methods: An open, unblinded, multi-centre randomised controlled trial in two Australian public hospitals. 112 children (0-16 years) fulfilling the inclusion criteria will be randomised to one of two clinical pathways for management of their chronic health condition: (1) integrated children's care clinic (ICCC) or (2) self-directed care pathway. All children and caregivers will be interviewed at 1 week, and 3, 6 and 12 month time intervals. Primary outcome measures include the Pediatric Quality of Life (PedQOL) questionnaire, Subjective Units of Distress Scale, Child Behaviour Checklist (CBCL) and Rotter's Locus of Control Scale. Secondary outcome measures include the total number of medical appointments, school days missed and quantity of services accessed. Our main objectives are to determine if the ICCC results in better health and economics outcomes compared to the self-directed care pathway. Discussion: The success of a health systems approach needs to be balanced against clinical, mortality and cost-effectiveness data for long-term sustainability within a publicly funded health system. A clinical pathway that is sustainable, cost-effective, provides efficient evidence-based care and improves the quality of life outcomes for children with chronic health conditions has the potential to reduce waitlist times, improve access to health services, increase consumer satisfaction; and prevent costs associated with poorly managed chronic health conditions into adulthood. This study will be the first to provide clinical and health economics data on an integrated care pathway for the management of chronic health conditions in children. On a broader scale, results from this study will help guide care coordination frameworks for children with chronic health conditions; particularly with the introduction and implementation of a National Disability Insurance Scheme (NDIS) across Australia.The study is funded by an experienced researcher grant from Allied Health Professions of Queensland (AHPOQ) – Health Practitioner Research Scheme (Government body). AHPOQ’s role in this study is purely related to funding and had no role in the study design.

AB - Background: Children with chronic health conditions have better health-related outcomes when their care is managed in a personalised and coordinated way. However, increased demand on Australian ambulatory care hospital services has led to longer waitlist times to access specialists and appropriate intervention services; placing vulnerable children at increased risk of poorer short-term (e.g. social difficulties) and long-term (e.g. convictions) health and social outcomes. Traditional approaches to increasing frequency and service of delivery are expensive and can have minimal impact on caregiver burden. A community based service-integration approach, rather than self-directed care is proposed as increased service linkages are more likely to occur and improve the health outcomes of children with a chronic health condition. Methods: An open, unblinded, multi-centre randomised controlled trial in two Australian public hospitals. 112 children (0-16 years) fulfilling the inclusion criteria will be randomised to one of two clinical pathways for management of their chronic health condition: (1) integrated children's care clinic (ICCC) or (2) self-directed care pathway. All children and caregivers will be interviewed at 1 week, and 3, 6 and 12 month time intervals. Primary outcome measures include the Pediatric Quality of Life (PedQOL) questionnaire, Subjective Units of Distress Scale, Child Behaviour Checklist (CBCL) and Rotter's Locus of Control Scale. Secondary outcome measures include the total number of medical appointments, school days missed and quantity of services accessed. Our main objectives are to determine if the ICCC results in better health and economics outcomes compared to the self-directed care pathway. Discussion: The success of a health systems approach needs to be balanced against clinical, mortality and cost-effectiveness data for long-term sustainability within a publicly funded health system. A clinical pathway that is sustainable, cost-effective, provides efficient evidence-based care and improves the quality of life outcomes for children with chronic health conditions has the potential to reduce waitlist times, improve access to health services, increase consumer satisfaction; and prevent costs associated with poorly managed chronic health conditions into adulthood. This study will be the first to provide clinical and health economics data on an integrated care pathway for the management of chronic health conditions in children. On a broader scale, results from this study will help guide care coordination frameworks for children with chronic health conditions; particularly with the introduction and implementation of a National Disability Insurance Scheme (NDIS) across Australia.The study is funded by an experienced researcher grant from Allied Health Professions of Queensland (AHPOQ) – Health Practitioner Research Scheme (Government body). AHPOQ’s role in this study is purely related to funding and had no role in the study design.

UR - http://www.scopus.com/inward/record.url?scp=85042175355&partnerID=8YFLogxK

U2 - 10.1186/s12887-018-1034-x

DO - 10.1186/s12887-018-1034-x

M3 - Article

VL - 18

JO - BMC Pediatrics

JF - BMC Pediatrics

SN - 1471-2431

IS - 1

M1 - 72

ER -