AHRQ Study Finds That New Tool Identifies Children With Complex Chronic Disease

A new study, funded by AHRQ and the Centers for Medicare & Medicaid Services, found that a tool called the Pediatric Medical Complexity Algorithm (PMCA) can identify children with complex chronic disease. The tool was designed to allow Medicaid and other health care programs to target limited health care resources for care coordination to children with the most need. The PMCA is based on the Chronic Disability Payment System algorithms developed by AHRQ Director Richard Kronick, Ph.D. It was developed and tested for specificity and sensitivity by studying records for 700 children insured by the Washington State Medicaid program and treated at Seattle Children’s Hospital during at least one emergency department visit and/or inpatient stay in 2010. The PMCA correctly identified children with and without complex chronic disease, but it was unable to identify children with noncomplex chronic disease. The study and abstract of “Pediatric Medical Complexity Algorithm: A New Method to Stratify Children by Medical Complexity” are featured in the May 12 online issue of Pediatrics.