title: [Models of care and classification of "Children with special health care needs-CSHCN": Recommendations from the CSHCN Committee, Chilean Paediatric Society].
abstract: "Children with special health care needs" (CSHCN) is an emerging and heterogeneous group of paediatric patients, with a wide variety of medical conditions and with different uses of health care services. There is consensus on how to classify and assess these patients according to their needs, but not for their specific diagnosis. Needs are classified into 6 areas: a) specialised medical care; b) use or need of prescription medication; c) special nutrition; d) dependence on technology; e) rehabilitation therapy for functional limitation; and f) special education services. From the evaluation of each area, a classification for CSHCN is proposed according to low, medium, or high complexity health needs, to guide and distribute their care at an appropriate level of the health care system. Low complexity CSHCN should be incorporated into Primary Care services, to improve benefits for patients and families at this level. It is critical to train health care professionals in taking care of CSHCN, promoting a coordinated, dynamic and communicated work between different levels of the health care system. Compliance with these guidelines will achieve a high quality and integrated care for this vulnerable group of children.
authors.affiliation: División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Flores Cano
authors.affiliation: División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Centro UC Síndrome de Down, Santiago, Chile. Electronic address: mlizama@med.puc.cl.
authors.forename: Macarena
authors.initials: M
authors.lastname: Lizama Calvo
authors.affiliation: Hospital Roberto del Río, Departamento de Pediatría, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
authors.forename: Natalie
authors.initials: N
authors.lastname: Rodríguez Zamora
authors.affiliation: Unidad de NINEAS, Complejo Asistencial Dr. Sótero del Río, SSMSO, Santiago, Chile.
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: Ávalos Anguita
authors.affiliation: Hospital Roberto del Río, Departamento de Pediatría, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
authors.forename: Mónica
authors.initials: M
authors.lastname: Galanti De La Paz
authors.affiliation: División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Salesa
authors.initials: S
authors.lastname: Barja Yañez
authors.affiliation: Programa de salud de la Infancia, Departamento Ciclo Vital División de prevención y control de enfermedades, Subsecretaría de Salud Pública, Ministerio de Salud de Chile, Santiago, Chile.
authors.forename: Carlos
authors.initials: C
authors.lastname: Becerra Flores
authors.affiliation: Hospital Padre Hurtado, SSMSO, Santiago, Chile.
authors.forename: Carolina
authors.initials: C
authors.lastname: Sanhueza Sepúlveda
authors.affiliation: Unidad de NINEAS, Complejo Asistencial Dr. Sótero del Río, SSMSO, Santiago, Chile.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Cabezas Tamayo
authors.affiliation: Unidad NANEAS, Hospital Clínico San Borja Arriarán, SSMC, Santiago, Chile.
authors.forename: Jorge
authors.initials: J
authors.lastname: Orellana Welch
authors.affiliation: Facultad de Odontología, Universidad de Chile, Santiago, Chile.
authors.forename: Gisela
authors.initials: G
authors.lastname: Zillmann Geerdts
authors.affiliation: Unidad NANEAS, Hospital Clínico San Borja Arriarán, SSMC, Santiago, Chile.
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Antilef
authors.affiliation: Hospital Clínico, Red de Salud UC CHRISTUS, Santiago, Chile.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Cox Melane
authors.affiliation: Facultad de Odontología, Universidad de Chile, Santiago, Chile.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Valle Maluenda
authors.affiliation: Sede Occidente, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
authors.forename: Nelson
authors.initials: N
authors.lastname: Vargas Catalán
mesh_terms: D002648:Child; D002677:Chile; D003695:Delivery of Health Care / Q000458:organization & administration*; D019983:Guideline Adherence; D006301:Health Services Needs and Demand; D006801:Humans; D017146:Models, Organizational; D020380:Needs Assessment; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration
keywords: Atención primaria; Chronic disease; Clasificación; Classification; Disability; Discapacidad; Enfermedades crónicas; Paediatrics; Pediatría; Primary health care