Children with Special Health Care Needs: Trajectories That Can Differ in Outcomes

By: Lewis First, MD, MS; Editor-in-Chief  

U.S. Army

          Children with special health care needs (CSHN) are often referred to as just that—a homogeneous grouping that requires additional medical attention and resources more so than any other pediatric population.  Yet close-up these children are not homogeneous but vary in their trajectories in terms of their outcomes over time. Quach et al. (doi: 10.1542/peds.2014-2431) opted to study CSHN and defined four different trajectories that produced very different outcomes.

      The four trajectories involved some children whose special health care needs were persistent over time, some whose problem kept emerging over time, some whose issues were transient and some nonexistent over time.  If one can identify the trajectory a child might be on, it might help us prioritize which children need which resources, when and for how long. 

    That is just what the authors do in this study and to further emphasize its import, editorial board member Dr. Jeanne Van Cleave (doi: 10.1542/peds.2015-0319) offers a commentary that helps us learn how to provide better individual care through the use of population data.  In this case, a picture of these trajectories is worth much more than the words in this blog, so read the study and learn more.

Related Links:

•         Medical Home and Out-of-Pocket Medical Costs for Children With Special Health Care Needs
•         Care Coordination and Unmet Specialty Care Among Children With Special Health Care Needs

A Five-Year Report from the Pediatric AIDS Corps

By: Lewis First, MD, MS

In 2005, the Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI) created a global health corps—the Pediatric AIDS Corps (PAC) to provide clinical and educational programs to bring better AIDS care to parts of the world where it was most needed.

Students in the Central African Republic learning about HIV/AIDS
Photo by Pierre Holtz for UNICEF via Flickr

Schutze et al. (doi: 10.1542/ peds.2013-2938) have compiled five years’ worth of evaluative descriptive data combined with surveys of PAC physicians to help us better understand the importance of this remarkable program and the magnitude of its accomplishments in such a short period of time.

One comes away from this special article appreciating the global health work of the PAC and wanting to know more about how to expand its work even more—perhaps at a national level, given the positive outcomes being obtained. Journey with the PAC team by reading this five-year report and learning more.

Related Reading:

• Pediatrics: The Pediatric AIDS Corps: Responding to the African HIV/AIDS Health Professional Resource Crisis