Children with medical complexity (CMC) typically require care from multiple pediatric subspecialists. A complex care clinic may provide them regular longitudinal care on an inpatient and outpatient basis, sometimes helping coordinate the specialty care they need. While some complex care clinics provide all services associated with primary care, most do not.
As a result, most families seek a separate community or hospital-based source of pediatric primary care to improve access to care. Primary care physicians (PCP) care for the majority of CMC. This aligned with the CARE Award findings, which showed that 60% of the enrolled children were based in primary care practice settings. But the definition of roles and how care coordination works among specialists, complex care clinics, and community-based primary care settings are often unclear to families.
Studies have show that when primary care is present and valued in the delivery system, communities have better public health outcomes and lower health care costs. These results could apply to any system serving CMC. Four fundamental and necessary characteristics for primary care include:
- First contact for each need.
- Longitudinally involved over time.
- Comprehensive in its services.
- Coordinated in its relationship with the larger systems of care.