Relocating pediatric, hospital-based care towards preventive care: a qualitative study on modular care provision for children with developmental disabilities

The aim of this study is to identify tasks and requirements for relocating healthcare for children with developmental disabilities in the Netherlands using a modular perspective. We conducted semi-structured interviews with three pediatricians and four youth public health physicians providing care for children with developmental disabilities in a southeastern region of the Netherlands. Additionally, we conducted ten practice observations. The data were analyzed using thematic analysis. We were able to visualize healthcare provision for children with developmental disabilities. This enabled us to identify modules-collections of tasks-which revealed opportunities and requirements to relocate certain care tasks from pediatricians to youth public health physicians.

CONCLUSION: This study identified relocation opportunities for healthcare provision for children with developmental disabilities from pediatric care towards preventive care revealing duplication in care delivery. Also, this study identified five organizational requirements for relocation of care: adequate information and communications technology systems, clear agreements between parties involved, financial arrangements, knowledge and skills, and a shared desire. Relocation offers several potential benefits such as reducing workload and costs and improving care coherence and patient and family satisfaction.

WHAT IS KNOWN: • Relocating care-shifting tasks from pediatric care to primary or preventive care- is increasingly used to reduce costs, with evidence showing that such shifts can maintain care quality while lowering risks and expenses.

WHAT IS NEW: • We identify the organizational requirements for relocation of healthcare for children with developmental disabilities by revealing which tasks can be relocated and to whom.