IMPORTANCE There is a paucity of high-quality evidence on the effect of care coordination on health-related quality of life among children with chronic noncomplex medical conditions (non-CMCs). OBJECTIVE To examine whether care coordination delivered by an Allied Health Liaison Officer results in improved quality-of-life (QOL) outcomes for children with chronic non-CMCs and their families. DESIGN, SETTING AND PARTICIPANTS This multicenter, open label, randomized clinical trial was conducted in pediatric outpatient clinics at 3 Australian hospitals with tertiary- and secondary-level pediatric care facilities. A total of 81 children with chronic non-CMCs and their families participated in the trial for a period of up to 12 months between October 2017 to October 2020. Primary care reviews were offered at 1 week, 3 months, and 6 months after diagnosis. INTERVENTIONS Eligible children were randomized 1:1 to receive care coordination or standard care. Families of children receiving care coordination were provided access to an Allied Health Liaison Officer, who was responsible for facilitation of health care access across hospital, education, primary care, and community sectors. MAIN OUTCOMES AND MEASURES The primary outcomes were scores on the Pediatric Quality of Life Inventory (PedsQL), version 4.0, and the PedsQL Family Impact Module, version 2.0, measured at 6 and 12 months. An intent-to-treat approach was used to analyze the data. RESULTS Of 81 children (mean [SD] age, 8.2 [3.5] years; 55 [67.9%] male), 42 (51.9%) were randomized to care coordination and 39 (48.1%) to standard care. Compared with standard care, care coordination resulted in greater improvements in overall PedsQL scores (difference in score changes between groups, 7.10; 95% CI, 0.44-13.76; P = .04), overall PedsQL Family Impact Module scores (difference in score changes between groups, 8.62; 95% CI, 1.07-16.16; P = .03), and family functioning QOL (difference in score changes between groups, 15.83; 95% CI, 5.05-26.62; P = .004) at 12 months after diagnosis. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, care coordination improved the quality of life of children with chronic non-CMCs and their families. Further studies should explore specific non-CMCs that may benefit most from care coordination and whether an orientation among health services to provide such a coordination model could lead to longer-term improved clinical outcomes. TRIAL REGISTRATION http://anzctr.org.au Identifier: ACTRN12617001188325.

中文翻译：

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使用联合健康联络官对儿童慢性非复杂疾病进行护理协调的效果：一项多中心随机临床试验。

重要性 关于护理协调对患有慢性非复杂疾病 (non-CMC) 的儿童的健康相关生活质量的影响，缺乏高质量的证据。目的 检验联合卫生联络官提供的护理协调是否会改善患有慢性非 CMC 的儿童及其家人的生活质量 (QOL)。设计、地点和参与者 这项多中心、开放标签、随机临床试验在澳大利亚 3 家拥有三级和二级儿科护理设施的医院的儿科门诊进行。2017 年 10 月至 2020 年 10 月，共有 81 名患有慢性非 CMC 的儿童及其家人参加了长达 12 个月的试验。初级保健审查在 1 周、3 个月、诊断后 6 个月。干预 符合条件的儿童按 1:1 的比例随机分配接受护理协调或标准护理。接受护理协调的儿童家庭可以接触到联合健康联络官，该联络官负责促进医院、教育、初级保健和社区部门的医疗保健服务。主要结果和测量 主要结果是在 6 个月和 12 个月时测量的儿科生活质量量表 (PedsQL) 4.0 版和 PedsQL 家庭影响模块 2.0 版的分数。使用意向治疗方法分析数据。结果 在 81 名儿童（平均 [SD] 年龄，8.2 [3.5] 岁；55 名 [67.9%] 男性）中，42 名 (51.9%) 被随机分配到护理协调组，39 名 (48.1%) 被随机分配到标准护理组。与标准护理相比，护理协调导致总体 PedsQL 分数（组间分数变化差异，7.10；95% CI，0.44-13.76；P = .04）、总体 PedsQL 家庭影响模块分数（组间分数变化差异，8.62；P = .04）诊断后 12 个月时的 95% CI，1.07-16.16；P = .03）和家庭功能 QOL（组间评分变化差异，15.83；95% CI，5.05-26.62；P = .004）。结论和相关性 在这项随机临床试验中，护理协调改善了患有慢性非 CMC 的儿童及其家人的生活质量。进一步的研究应该探索可能从护理协调中获益最多的特定非 CMC，以及在卫生服务中提供这种协调模型的方向是否可以导致长期改善的临床结果。试用注册 http://anzctr.org。