Understanding care use of children with complex problems : a family and care perspective

The aim of this dissertation is to enhance understanding of care use by children known to have or be at risk of complex problems (CP). Children with CP have a greater need for health services than the average child because their chronic physical, behavioral or emotional conditions interact and enhance their vulnerability. Worldwide, around 5% of children suffer from complex problems. They typically have high levels of care consumption, especially psychosocial care.In our studies we address factors impacting care use of children with CP, its intensity, and barriers to care. We found several risk factors for identification of these children: child’s age, adverse life events, child’s psychosocial problems, and parenting concerns. We also look at care use of multiproblem families, involving a subgroup of these children with the highest level of CP. Finally, we studied professionals to understand the challenges they meet in organizing care for these children when using Wraparound Care. This care-coordination method is used in the Netherlands as the backbone of treatment for children with CP. Further development of Wraparound Care and greater understanding of the factors impacting care use by children with CP will help to make their pathway to care more efficient and effective.ZonMWLUMC / Geneeskund