Framework for identifying children who have chronic conditions

The case for a new definition

Ruth E. K. Stein, Laurie J. Bauman, Lauren E. Westbrook, Susan M. Coupey, Henry T. Ireys

Research output: Contribution to journalArticle

198 Citations (Scopus)

Abstract

Efforts to identify children with ongoing health conditions generally rely on lists of diagnoses. However, there has been a growing trend to use a noncategorical, or generic, approach in which such children are identified by the consequences of their condition. Recent legislation and the Supreme Court decision in Sullivan v Zebley adopt this broader concept and mandate that a noncategorical approach be used in determining eligibility for services and benefits. Traditional condition lists are less desirable because (1) every disorder to which children are subject cannot be included (2) diagnoses may be applied inconsistently by clinicians and across settings, (3) condition labels alone do not convey the extent of morbidity for individuals, (4) there is a bias toward identifying only those children who have access to the medical care system, and (5) there is often a gap between emergence of symptoms or consequences and diagnosis. We developed a noncategorical framework for identifying children with ongoing health conditions that responds to the federal mandate and uses consequences of disorders, rather than diagnostic labels. It can be applled to meet the objectives of services, research, policy, reimbursement, or program eligibility; is consistent across diagnoses; is descriptive of the impact of morbidity; is adaptable to meet specific purposes; and can be modified by imposing different severity levels. Our screening tool will soon be available for practical use.

Original languageEnglish (US)
Pages (from-to)342-347
Number of pages6
JournalThe Journal of Pediatrics
Volume122
Issue number3
DOIs
StatePublished - 1993

Fingerprint

Supreme Court Decisions
Morbidity
Health
Legislation
Research

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Framework for identifying children who have chronic conditions : The case for a new definition. / Stein, Ruth E. K.; Bauman, Laurie J.; Westbrook, Lauren E.; Coupey, Susan M.; Ireys, Henry T.

In: The Journal of Pediatrics, Vol. 122, No. 3, 1993, p. 342-347.

Research output: Contribution to journalArticle

@article{6a518393ab07448fa1396a2b3fecd093,
title = "Framework for identifying children who have chronic conditions: The case for a new definition",
abstract = "Efforts to identify children with ongoing health conditions generally rely on lists of diagnoses. However, there has been a growing trend to use a noncategorical, or generic, approach in which such children are identified by the consequences of their condition. Recent legislation and the Supreme Court decision in Sullivan v Zebley adopt this broader concept and mandate that a noncategorical approach be used in determining eligibility for services and benefits. Traditional condition lists are less desirable because (1) every disorder to which children are subject cannot be included (2) diagnoses may be applied inconsistently by clinicians and across settings, (3) condition labels alone do not convey the extent of morbidity for individuals, (4) there is a bias toward identifying only those children who have access to the medical care system, and (5) there is often a gap between emergence of symptoms or consequences and diagnosis. We developed a noncategorical framework for identifying children with ongoing health conditions that responds to the federal mandate and uses consequences of disorders, rather than diagnostic labels. It can be applled to meet the objectives of services, research, policy, reimbursement, or program eligibility; is consistent across diagnoses; is descriptive of the impact of morbidity; is adaptable to meet specific purposes; and can be modified by imposing different severity levels. Our screening tool will soon be available for practical use.",
author = "Stein, {Ruth E. K.} and Bauman, {Laurie J.} and Westbrook, {Lauren E.} and Coupey, {Susan M.} and Ireys, {Henry T.}",
year = "1993",
doi = "10.1016/S0022-3476(05)83414-6",
language = "English (US)",
volume = "122",
pages = "342--347",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Framework for identifying children who have chronic conditions

T2 - The case for a new definition

AU - Stein, Ruth E. K.

AU - Bauman, Laurie J.

AU - Westbrook, Lauren E.

AU - Coupey, Susan M.

AU - Ireys, Henry T.

PY - 1993

Y1 - 1993

N2 - Efforts to identify children with ongoing health conditions generally rely on lists of diagnoses. However, there has been a growing trend to use a noncategorical, or generic, approach in which such children are identified by the consequences of their condition. Recent legislation and the Supreme Court decision in Sullivan v Zebley adopt this broader concept and mandate that a noncategorical approach be used in determining eligibility for services and benefits. Traditional condition lists are less desirable because (1) every disorder to which children are subject cannot be included (2) diagnoses may be applied inconsistently by clinicians and across settings, (3) condition labels alone do not convey the extent of morbidity for individuals, (4) there is a bias toward identifying only those children who have access to the medical care system, and (5) there is often a gap between emergence of symptoms or consequences and diagnosis. We developed a noncategorical framework for identifying children with ongoing health conditions that responds to the federal mandate and uses consequences of disorders, rather than diagnostic labels. It can be applled to meet the objectives of services, research, policy, reimbursement, or program eligibility; is consistent across diagnoses; is descriptive of the impact of morbidity; is adaptable to meet specific purposes; and can be modified by imposing different severity levels. Our screening tool will soon be available for practical use.

AB - Efforts to identify children with ongoing health conditions generally rely on lists of diagnoses. However, there has been a growing trend to use a noncategorical, or generic, approach in which such children are identified by the consequences of their condition. Recent legislation and the Supreme Court decision in Sullivan v Zebley adopt this broader concept and mandate that a noncategorical approach be used in determining eligibility for services and benefits. Traditional condition lists are less desirable because (1) every disorder to which children are subject cannot be included (2) diagnoses may be applied inconsistently by clinicians and across settings, (3) condition labels alone do not convey the extent of morbidity for individuals, (4) there is a bias toward identifying only those children who have access to the medical care system, and (5) there is often a gap between emergence of symptoms or consequences and diagnosis. We developed a noncategorical framework for identifying children with ongoing health conditions that responds to the federal mandate and uses consequences of disorders, rather than diagnostic labels. It can be applled to meet the objectives of services, research, policy, reimbursement, or program eligibility; is consistent across diagnoses; is descriptive of the impact of morbidity; is adaptable to meet specific purposes; and can be modified by imposing different severity levels. Our screening tool will soon be available for practical use.

UR - http://www.scopus.com/inward/record.url?scp=0027453180&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027453180&partnerID=8YFLogxK

U2 - 10.1016/S0022-3476(05)83414-6

DO - 10.1016/S0022-3476(05)83414-6

M3 - Article

VL - 122

SP - 342

EP - 347

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 3

ER -