Use of the interRAI PEDS HC in children receiving home care in Ontario, Canada

Emily Thorburn-Winsor; Megan Doherty; Aaron Jones; Christina Vadeboncoeur

doi:10.1186/s12913-022-08442-z

Use of the interRAI PEDS HC in children receiving home care in Ontario, Canada

BMC Health Serv Res. 2022 Aug 18;22(1):1057. doi: 10.1186/s12913-022-08442-z.

Authors

Emily Thorburn-Winsor¹, Megan Doherty^{2

3

4}, Aaron Jones^{1

5}, Christina Vadeboncoeur^{6

7

8}

Affiliations

¹ Michael G. DeGroote School of Medicine, McMaster University, ON, Hamilton, Canada.
² Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.
³ University of Ottawa, Ottawa, Ontario, Canada.
⁴ Roger Neilson House, Ottawa, Ontario, Canada.
⁵ Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
⁶ Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada. vadeboncoeur@cheo.on.ca.
⁷ University of Ottawa, Ottawa, Ontario, Canada. vadeboncoeur@cheo.on.ca.
⁸ Roger Neilson House, Ottawa, Ontario, Canada. vadeboncoeur@cheo.on.ca.

Abstract

Background: There is no standard assessment tool for pediatric home care recipients in Canada, limiting the availability of comparable, population-based data. The objective of this study was to describe pediatric home care recipients who were part of a pilot implementation of the interRAI Pediatric Home Care Assessment Form (PEDS-HC) among medically complex children referred to home care agencies in three regions in Ontario, Canada.

Methods: All 14 agencies providing home care to children in Ontario were invited to participate in the pilot project, and 9 participated in an education session. Three of these agencies used the PEDS-HC during the pilot implementation between February 2018 and March 2020. We used de-identified data to describe the demographics, home care needs, and diagnoses of pediatric home care recipients.

Results: The sample of 474 assessments was predominantly male (60.34%), with an average age at assessment of 12.36 years (SD 4.56). Most (78.48%) reported English as their primary language. Most children assessed had between two and eight medical diagnoses. Diagnoses reported varied: gastrointestinal, musculoskeletal, respiratory and neurological conditions were most common. The prevalence of urinary incontinence (40.1%) and bowel incontinence (70.9%) were high. Over 60% of children were rarely or only sometimes understood. A majority of children had adequate hearing (83.5%) and vision (68.6%). Extensive services were being provided in 10% of children assessed. Most children received care both at school and at home (70.89%), with 20.89% receiving home care only.

Conclusions: The PEDS-HC provides a detailed, standardised descriptive profile of medically complex children receiving home care. Expanding use of PEDS-HC would promote consistency in care planning and delivery on the patient level, enable cross-jurisdictional comparisons, and inform utilization tracking and health care funding decisions on the organization and provincial levels.

Keywords: Children with medical complexity; PEDS-HC; Pediatric home care; Standardised assessment; interRAI.

MeSH terms

Child
Female
Home Care Services*
Humans
Male
Ontario / epidemiology
Palliative Care
Pilot Projects
Prevalence