TY  - CHAP
M1  - Book, Section
TI  - The Child With Special Healthcare Needs
A1  - Abramo, Thomas
A1  - Porter, Nicholas W.
A1  - Selby, Samuel T.
A2  - Tintinalli, Judith E.
A2  - Ma, O. John
A2  - Yealy, Donald M.
A2  - Meckler, Garth D.
A2  - Stapczynski, J. Stephan
A2  - Cline, David M.
A2  - Thomas, Stephen H.
PY  - 2020
T2  - Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e
AB  - Children  with  special  healthcare  needs  (CSHCN)  have  or  are  at  increased  risk  for  chronic  physical,  developmental,  behavioral,  or  emotional  conditions  and  require  health  and  related  services  of  a  type  or  amount  beyond  those  required  by  children  generally.1,2  This  group  of  children  encompasses  a  wide  spectrum  of  medical  complexity,  functional  limitations,  and  resource  utilization.3,4  A  subset  of  the  CSHCN  population,  children  with  medical  complexity  have  substantial  healthcare  service  and  resource  needs  for  their  chronic  conditions.4,5  Their  response  to  illness  and  trauma  may  be  unpredictable  compared  with  the  normal  pediatric  patient,  sometimes  leading  to  a  rapid  and  unexpected  deterioration.  This  requires  a  personalized  approach  that  addresses  their  special  needs  and  chronic  medical  problems  in  addition  to  the  emergency  medical  condition  at  hand.  This  unique  response  to  illness  and  injury  accounts  for  the  majority  of  pediatric  hospital  days  and  deaths  in  this  group.4,6  CSHCN  is  a  growing  population,  accounting  for  15%  to  18%  (11.2  million)  of  children  in  the  United  States7,8  and  for  40%  to  80%  of  all  pediatric  healthcare  utilization  and  costs.7,9,10,11  These  trends  are  largely  due  to  increased  survival  of  premature  infants  and  improved  medical  or  surgical  treatment  of  conditions  that  were  once  terminal.5,6  Compared  to  typical  children,  children  with  chronic  conditions  tend  to  be  older,  male,  and  from  white  racial  or  ethnic  groups.8,10-13  The  clinical  spectrum  of  CSHCN  conditions  is  diverse,  and  complex  medical  devices  are  often  required  for  care  (Tables  148-1  and  148-2).10-12,14-17  Because  of  the  increasing  prevalence  of  this  patient  population  and  their  high  rate  of  healthcare  utilization,  emergency  medical  practices  must  adapt  to  meet  the  needs  of  this  complex  group.18  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessemergencymedicine.mhmedical.com/content.aspx?aid=1166596568
ER  -