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Open AccessCommentary

Specialized Care without the Subspecialist: A Value Opportunity for Secondary Care

1
Department of Pediatrics and Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5G 1X8, Canada
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Division of Pediatric Medicine, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
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Center for Policy, Outcomes and Prevention and Division of General Pediatrics, Stanford University, Stanford, CA 94305, USA
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Department of Pediatrics, Boston University School of Medicine, Boston, MA 02118, USA
*
Author to whom correspondence should be addressed.
Children 2018, 5(6), 69; https://doi.org/10.3390/children5060069
Received: 10 April 2018 / Revised: 22 May 2018 / Accepted: 30 May 2018 / Published: 4 June 2018
(This article belongs to the Special Issue 5th Anniversary Issue)
An underutilized value strategy that may reduce unnecessary subspecialty involvement in pediatric healthcare targets the high-quality care of children with common chronic conditions such as obesity, asthma, or attention deficit hyperactivity disorder within primary care settings. In this commentary, we propose that “secondary care”, defined as specialized visits delivered by primary care providers, a general pediatrician, or other primary care providers, can obtain the knowledge, skill and, over time, the experience to manage one or more of these common chronic conditions by creating clinical time and space to provide condition-focused care. This care model promotes familiarity, comfort, proximity to home, and leverages the provider’s expertise and connections with community-based resources. Evidence is provided to prove that, with multi-disciplinary and subspecialist support, this model of care can improve the quality, decrease the costs, and improve the provider’s satisfaction with care. View Full-Text
Keywords: primary care; subspecialty care; multidisciplinary care; chronic conditions; healthcare delivery; health services research primary care; subspecialty care; multidisciplinary care; chronic conditions; healthcare delivery; health services research
MDPI and ACS Style

Cohen, E.; Wang, C.J.; Zuckerman, B. Specialized Care without the Subspecialist: A Value Opportunity for Secondary Care. Children 2018, 5, 69.

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