Experiences of inpatient healthcare services among children with medical complexity: A scoping review
Bibliographic record
Abstract
Background: Children with medical complexity (CMC) have multiple chronic conditions in addition to highly complex care needs. The population of CMC has increased considerably in the recent decade and has among the highest health care utilization in pediatrics. CMC and their parental caregivers' experiences of care differ in important ways from other populations and CMC and their parental caregivers have reported poor experiences of care when compared to other pediatric populations. Importantly, CMC are at increased risk of adverse events during their hospitalizations. Objective: The objective of this review is to map the existing literature related to CMC and their parental caregivers’ experiences of receiving inpatient healthcare services, and to identify important knowledge gaps. Inclusion criteria: This review will include studies pertaining to the experiences of healthcare services for CMC, along with their parental caregivers, in the inpatient hospital setting. In our review, CMC are defined as children with (a) multiple chronic conditions, (b) high health care utilization, (c) high care needs in the home and community, and (c) functional limitations. Experiences of health care is described as interactions shaped by an organization's culture that influence patients' perceptions across the continuum of care. Unique settings, such as the NICU and mental health units, and populations, such as medically fragile infants, will be excluded. Methods: Using the Joanna Briggs Institute methodology, articles related to CMC and the inpatient care setting will be identified through EMBASE, CINAHL, Web of Science, MEDLINE and PsycInfo. Search period will be from the year 2000 to the current date. All types of research designs will be included but not grey literature. Studies will be limited to English. Screening of titles, abstracts and full-text articles will be conducted by two independent researchers. Disagreements will be resolved by discussion with a third researcher. Data will be extracted using a data extraction form including authors, country, participants, objectives, methodology, setting and key findings. Articles will be appraised with the Consolidated Criteria for Reporting Qualitative Studies (COREQ), Newcastle-Ottawa Scale (NOS) for cohort and case-control studies and the Consolidated Standards of Reporting Trials (CONSORT) for randomized controlled trials. Data tables and figures will be created to map and present data, and themes from data will be presented in a narrative summary. Significance: This review will aid in developing a comprehensive understanding of inpatient experiences of care for CMC and their parental caregivers. This understanding will contribute to further research on the development of models of care and potential interventional research projects among CMC and their parental caregivers in inpatient hospital settings. Collating and mapping this evidence is necessary to determine critical aspects of experiences of care that will help prioritize health services interventions and evaluation, as well as identify areas that require further investigation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.013 | 0.019 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".