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Increasing prevalence of medically complex children in US hospitals
Katherine H Burns1, Patrick H Casey, Robert E Lyle
1Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, 1 Children's Way, Slot 512-41, Little Rock, AR 72202, USA. burnskatherinel@uams.edu
Insights
Hospitalization rates for medically complex children with multiple chronic conditions increased significantly from 1991 to 2005. This trend highlights a growing need for specialized pediatric care and resource allocation.
Area of Science:
- Pediatric healthcare utilization
- Public health trends
- Complex chronic conditions (CCCs)
Background:
- Medically complex children represent a growing population with significant healthcare needs.
- Understanding trends in their hospitalization is crucial for healthcare planning.
- Previous research indicates a rise in chronic conditions among pediatric populations.
Purpose of the Study:
- To analyze national trends in hospital admissions for medically complex children over a 15-year period.
- To identify changes in the prevalence of hospitalizations for children with specific complex chronic conditions.
- To assess the increasing medical complexity of hospitalized pediatric patients.
Main Methods:
- Utilized national data from the Nationwide Inpatient Sample (NIS) from 1991 to 2005.
- Analyzed hospitalization rates in 3-year increments for children aged 8 days to 4 years with chronic conditions.
- Grouped discharge diagnoses into 9 categories of complex chronic conditions (CCCs) and examined trends individually and in combination.
Main Results:
- Hospitalization rates for children with multiple CCC diagnoses increased from 83.7 to 166 per 100,000 (1991-2005).
- Hospitalizations for children with cerebral palsy (CP) and additional CCCs rose from 7.1 to 10.4 per 100,000.
- Hospitalizations for bronchopulmonary dysplasia and multiple CCCs increased from 9.8 to 23.9 per 100,000.
Conclusions:
- Consistent increases in hospitalization rates were observed for children with multiple complex chronic conditions.
- Hospitalization rates for children with cerebral palsy alone remained stable.
- The overall medical complexity of hospitalized pediatric patients has demonstrably increased over the study period.
Objective:
In this study we used national data to determine changes in the prevalence of hospital admissions for medically complex children over a 15-year period.
Patients And Methods:
Data from the Nationwide Inpatient Sample, a component of the Healthcare Cost and Utilization Project, was analyzed in 3-year increments from 1991 to 2005 to determine national trends in rates of hospitalization of children aged 8 days to 4 years with chronic conditions. Discharge diagnoses from the Nationwide Inpatient Sample were grouped into 9 categories of complex chronic conditions (CCCs). Hospitalization rates for each of the 9 CCC categories were studied both individually and in combination. Trends of children hospitalized with 2 specific disorders, cerebral palsy (CP) and bronchopulmonary dysplasia, with additional diagnoses in more than 1 CCC category were also examined.
Results:
Hospitalization rates of children with diagnoses in more than 1 CCC category increased from 83.7 per 100,000 (1991-1993) to 166 per 100 000 (2003-2005) (P[r]<.001). The hospitalization rate of children with CP plus more than 1 CCC diagnosis increased from 7.1 to 10.4 per 100 000 (P=.002), whereas the hospitalization rates of children with bronchopulmonary dysplasia plus more than 1 CCC diagnosis increased from 9.8 to 23.9 per 100,000 (P<.001).
Conclusions:
Consistent increases in hospitalization rates were noted among children with diagnoses in multiple CCC categories, whereas hospitalization rates of children with CP alone have remained stable. The relative medical complexity of hospitalized pediatric patients has increased over the past 15 years.
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