title: Experts' Perspectives Toward a Population Health Approach for Children With Medical Complexity.
abstract: Because children with medical complexity (CMC) display very different health trajectories, needs, and resource utilization than other children, it is unclear how well traditional conceptions of population health apply to CMC. We sought to identify key health outcome domains for CMC as a step toward determining core health metrics for this distinct population of children.
  
  
  
  We conducted and analyzed interviews with 23 diverse national experts on CMC to better understand population health for CMC. Interviewees included child and family advocates, health and social service providers, and research, health systems, and policy leaders. We performed thematic content analyses to identify emergent themes regarding population health for CMC.
  
  
  
  Overall, interviewees conveyed that defining and measuring population health for CMC is an achievable, worthwhile goal. Qualitative themes from interviews included: 1) CMC share unifying characteristics that could serve as the basis for population health outcomes; 2) optimal health for CMC is child specific and dynamic; 3) health of CMC is intertwined with health of families; 4) social determinants of health are especially important for CMC; and 5) measuring population health for CMC faces serious conceptual and logistical challenges.
  
  
  
  Experts have taken initial steps in defining the population health of CMC. Population health for CMC involves a dynamic concept of health that is attuned to individual, health-related goals for each child. We propose a framework that can guide the identification and development of population health metrics for CMC.
authors.affiliation: Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, Calif; Children's Discovery & Innovation Institute, Mattel Children's Hospital UCLA, Los Angeles, Calif. Electronic address: ebarnert@mednet.ucla.edu.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Barnert
authors.affiliation: Department of Pediatrics, University of Wisconsin-Madison, Madison, Wis.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Coller
authors.affiliation: Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, Calif; Children's Discovery & Innovation Institute, Mattel Children's Hospital UCLA, Los Angeles, Calif.
authors.forename: Bergen B
authors.initials: BB
authors.lastname: Nelson
authors.affiliation: Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, Calif; Children's Discovery & Innovation Institute, Mattel Children's Hospital UCLA, Los Angeles, Calif.
authors.forename: Lindsey R
authors.initials: LR
authors.lastname: Thompson
authors.affiliation: Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, Calif.
authors.forename: Vincent
authors.initials: V
authors.lastname: Chan
authors.affiliation: Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, Calif; Children's Discovery & Innovation Institute, Mattel Children's Hospital UCLA, Los Angeles, Calif.
authors.forename: Cesar
authors.initials: C
authors.lastname: Padilla
authors.affiliation: Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, Calif; Children's Discovery & Innovation Institute, Mattel Children's Hospital UCLA, Los Angeles, Calif.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Klitzner
authors.affiliation: Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, Calif; Children's Discovery & Innovation Institute, Mattel Children's Hospital UCLA, Los Angeles, Calif.
authors.forename: Moira
authors.initials: M
authors.lastname: Szilagyi
authors.affiliation: Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, Calif; Children's Discovery & Innovation Institute, Mattel Children's Hospital UCLA, Los Angeles, Calif; Department of Health Policy & Management, UCLA Fielding School of Public Health, Los Angeles, Calif; RAND Health, RAND Corporation, Santa Monica, Calif.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Chung
mesh_terms: D001291:Attitude of Health Personnel; D002648:Child; D002662:Child Health Services / Q000458:organization & administration; D002675:Child, Preschool; D019988:Children with Disabilities / Q000523:psychology*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D020380:Needs Assessment; D018802:Patient-Centered Care; D000075485:Population Health; D016896:Treatment Outcome
keywords: children with medical complexity; children with special health care needs; complex chronic conditions; health outcomes; population health