The children enrolled had an average age of 5 years (7 to 19 years) and about 43% lived in disadvantaged areas (IRSAD < 5). Of the 534 registered, 446 (83.5%) A joint care plan was implemented, while the other 88 children included those who already had a current affairs plan, managed by the child`s medical team, but who needed additional support, or they only needed coordination of appointments. Of the 84 families who did not have a family doctor prior to enrollment, 58 (69%) after enrollment were related to their family doctor. The 24-hour hotline was launched at the end of 2016 and 55 (10.3%) Patients were associated with the hotline until June 2017. In addition, data on the number of ED accreditations and presentations were extracted from routine administrative data from the analysis and support of ANALYSIs and assistance from SCHN Management 6 months prior to registration and 6 months after enrollment in the care coordination service. Babies aged < 6 months at the time of enrollment were excluded from the calculations, as the reduction in pre-registration time would have distorted the results. Any child who died during the post-registration period was also excluded from the analysis. The Sydney Children`s Hospital Network (SCHNS) includes two large tertiary children`s hospitals in New South Wales (NSW), Australia – The Children`s Hospital at Westmead (CHW) and the Sydney Children`s Hospital (CHW). SCHNS is the largest paediatric health care provider in Australia and provides about 90% of all tertiary paediatric care in NSW. During the financial year from June 2015 to July 2016, there were 50,474 registrations, 23,467 daily registrations, 1,124,158 outpatient meetings and 96,288 ED presentations to THE SCHNS .
The gps kids service had a wide range in size with many different medical teams and caregivers who participated in the care of registered children. General medicine teams were most often involved in the care of children enrolled in the service. This is not surprising, as paediatric paediatricians often take care of specialized teams between appointments at all times. The Care Coordinators have encouraged the development of clinical partnerships between several clinical teams involved in the care of children with complex medical needs, by attending routine case review sessions and by establishing links with clinical nurse specialists and other important collaborators working with medical teams. These clinical partnerships have enabled specialized medical teams such as gastroenterology and rheumatology to integrate the practice of patient integration in the field where possible. Care coordinators proactively linked families with pediatricians in local hospitals or in the community to meet the child`s needs closer to home and away from tertiary/quaternary children`s hospitals.