title: The Impact of Telehealth and Care Coordination on the Number and Type of Clinical Visits for Children With Medical Complexity.
abstract: The purpose of this analysis was to evaluate the effects of an advanced practice nurse-delivered telehealth intervention on health care use by children with medical complexity (CMC). Because CMC account for a large share of health care use costs, finding effective ways to care for them is an important challenge requiring exploration.
  
  
  
  This was a secondary analysis of data from a randomized clinical trial with a control group and two intervention groups. The focus of the analysis was planned and unplanned clinical and therapy visits by CMC over a 30-month data collection period. Nonparametric tests were used to compare visit counts among and within the three groups.
  
  
  
  The number of unplanned visits decreased over time across all groups, with the greatest decrease in the video telehealth intervention group. Planned visits were higher in the video telehealth group across all time periods.
  
  
  
  Advanced practice registered nurse-delivered telehealth care coordination may support a shift from unplanned to planned health care service use among CMC.
authors.forename: Holly D
authors.initials: HD
authors.lastname: McKissick
authors.forename: Rhonda G
authors.initials: RG
authors.lastname: Cady
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Looman
authors.forename: Stanley M
authors.initials: SM
authors.lastname: Finkelstein
mesh_terms: D000293:Adolescent; D057179:Advanced Practice Nursing; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000191:economics / Q000628:therapy*; D015400:Clinical Nursing Research; D003266:Continuity of Patient Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D005260:Female; D017048:Health Care Costs; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D008297:Male; D009819:Office Visits / Q000191:economics*; D064701:Pediatric Nurse Practitioners; D015397:Program Evaluation; D011787:Quality of Health Care / Q000191:economics / Q000458:organization & administration*; D017216:Telemedicine / Q000458:organization & administration / Q000592:standards; D014481:United States
keywords: Care coordination; medical complexity; telehealth