Full, shared and hybrid paediatric care for cystic fibrosis in South and Mid Wales

Arch Dis Child. 2012 Jan;97(1):17-20. doi: 10.1136/adc.2010.199380. Epub 2011 Feb 13.


Background: Although care for children with cystic fibrosis (CF) is increasingly shared between CF centres and local CF clinics, the optimal model is unclear.

Objectives: The authors compared three models of care within a well established CF network: full centre care; local clinic based care with annual review by the CF centre; and hybrid care, where the child is usually reviewed at least three times a year by the specialist CF centre.

Results: Of 199 children and young people with CF in South and Mid Wales, 77 were receiving full care, 102 shared care and 20 hybrid care. There were no significant differences in baseline characteristics, nutritional outcomes or use of chronic therapies. There was however a statistically significant difference between full, shared and hybrid care in mean forced expiratory volume in 1 s (FEV(1)) per cent predicted (89.2% vs 74.5% vs 88.9%; p=0.001).

Conclusions: These differences in pulmonary function are likely to reflect the model of care received, and may affect long term outcomes.

MeSH terms

  • Adolescent
  • Adolescent Health Services / organization & administration
  • Child
  • Child Health Services / organization & administration
  • Child, Preschool
  • Cystic Fibrosis / physiopathology
  • Cystic Fibrosis / therapy*
  • Delivery of Health Care / organization & administration*
  • Female
  • Forced Expiratory Volume / physiology
  • Health Services Research
  • Humans
  • Infant
  • Male
  • Models, Organizational
  • Wales