Who benefits from a pediatric home care program?

The Pediatric Home Care (PHC) program is a treatment program that provides medical and psychosocial care and community-based services to chronically ill children. The program was started in 1970 and is staffed by pediatricians, pediatric nurses, and a social worker, who can provide care in the home, office, hospital, school, or community. The program supplies the child and family with information about the chronic condition and with training in self-care skills, and coordinates health services and social and community resources. The mental health benefits of the PHC program were evaluated at six months and one year after its implementation. The results were compared with those of a standard care program, which consisted of services provided by a university-affiliated hospital, its clinic system, and related community services. The PHC program resulted in greater improvement in the child's psychological adjustment, and in the mother's psychiatric symptoms and satisfaction with care as compared with the standard care program. However, the effects of chronic illness on the family and child's functional condition were similar for all patients. The differences in benefit gained from the PHC program were assessed in various subgroups of patients. The patients who benefited most from the PHC program were those with mild chronic illness, but with low coping resources, such as social, educational, financial, and personal support. In cases where the chronic illness was mild and coping resources were ample, the patient benefited more from standard care than from PHC. Results varied among patients with more severe chronic illness. These findings suggest that patients with immense needs may not derive the greatest benefit from intervention programs. Medical and social factors should be taken into consideration when planning the distribution of resources. (Consumer Summary produced by Reliance Medical Information, Inc.)