To identify tools for stratifying children with complex chronic conditions (CCC), evaluate their psychometric properties, and assess their suitability for widespread application. A scoping review was conducted using six electronic databases, targeting articles that included tools for identifying and stratifying children with CCC. Articles were selected if they were published within the last decade, focused on populations aged 0–25 years, and met predefined eligibility criteria. There were no language restrictions. Articles eligible for full-text review were screened by two independent reviewers with discrepancies resolved by a third reviewer. After this first extraction the original articles that recorded psychometric properties and characteristics of tools were consulted. From 5,422 articles, 16 were included, identifying nine tools. Key tools included PedCom, Expanded PedCom, and the Pediatric Medical Complexity Algorithm. Expanded PedCom was highlighted for its numerical precision, stratification capabilities, and excellent psychometric properties, classifying children into four levels of complexity. Conclusions: Tools like Expanded PedCom can standardise the classification of children with CCC, supporting tailored resource allocation and global comparisons. Incorporating such tools into healthcare systems ensures equitable resource distribution and improved care pathways. Expanded PedCom is recommended for use in English and Spanish contexts due to its precision and practicality.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> What is Known: • Children with chronic conditions and complex needs represent a growing population worldwide, yet their identification and stratification remain heterogeneous. The use of validated tools specifically designed for this population would enable more effective resource management to meet their needs. </entry> </row> <row> <entry nameend="c2" namest="c1"> What is New: • The review identified eight instruments for stratifying children with complex chronic conditions (CCC), with the Expanded PedCom emerging as the most robust due to its numerical strength and sound psychometric properties. • The scientific generalisation of stratification tools enables impactful national and global strategies. </entry> </row> </tbody> </tgroup> </Table>

Identification and stratification tools for children with chronic pathology and complexity: systematic scoping review

期刊论文
发表日期：

2025年10月16日

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Dorleta Lopez de Suso Martinez de Aguirre,
Carlos Martín Gómez,
Iñigo de Noriega Echevarría,
Ricardo Martino-Alba,
Raquel Jiménez García

摘要

To identify tools for stratifying children with complex chronic conditions (CCC), evaluate their psychometric properties, and assess their suitability for widespread application. A scoping review was conducted using six electronic databases, targeting articles that included tools for identifying and stratifying children with CCC. Articles were selected if they were published within the last decade, focused on populations aged 0–25 years, and met predefined eligibility criteria. There were no language restrictions. Articles eligible for full-text review were screened by two independent reviewers with discrepancies resolved by a third reviewer. After this first extraction the original articles that recorded psychometric properties and characteristics of tools were consulted. From 5,422 articles, 16 were included, identifying nine tools. Key tools included PedCom, Expanded PedCom, and the Pediatric Medical Complexity Algorithm. Expanded PedCom was highlighted for its numerical precision, stratification capabilities, and excellent psychometric properties, classifying children into four levels of complexity. Conclusions: Tools like Expanded PedCom can standardise the classification of children with CCC, supporting tailored resource allocation and global comparisons. Incorporating such tools into healthcare systems ensures equitable resource distribution and improved care pathways. Expanded PedCom is recommended for use in English and Spanish contexts due to its precision and practicality.

What is Known:

• Children with chronic conditions and complex needs represent a growing population worldwide, yet their identification and stratification remain heterogeneous. The use of validated tools specifically designed for this population would enable more effective resource management to meet their needs.

What is New:

• The review identified eight instruments for stratifying children with complex chronic conditions (CCC), with the Expanded PedCom emerging as the most robust due to its numerical strength and sound psychometric properties.

• The scientific generalisation of stratification tools enables impactful national and global strategies.