A cost analysis of a case management system for infants with chronic illnesses and developmental disabilities

Service coordination has long been a documented need of children with disabilities. The purpose of this study was to examine the costs associated with providing a comprehensive system of service coordination for hospitalized infants and toddlers with special health care needs and their families. Coordination costs were evaluated across seven functions including (a) determining eligibility for services, (b) identifying and arranging evaluations, (c) providing support to families, (d) making referrals to outside agencies, (e) exchanging information among service providers and families, (f) maintaining follow-up contact, and (g) determining discharge from the program. Results indicated that the service coordination function of providing family support was the most time-consuming task area, followed by the functions of exchanging information and maintaining follow-up contact. Costs also varied with the medical diagnosis and the child's age. Consistent with this variability, the diagnostic category and/or possibly the length of hospitalization was a better correlate of total cost of service coordination per child than was the number of months served. The complexity of the family's social and financial situation also appeared to be related to cost per month of service.