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Deciphering the Link Between Diagnosis-Related Group Weight and Nursing Care Complexity in Hospitalized Children: An

Manuele Cesare1, Fabio D'Agostino2, Emanuele Sebastiani3

  • 1Gemelli IRCCS University Hospital Foundation, 00168 Rome, Italy.

Children (Basel, Switzerland)
|January 25, 2025
PubMed

Insights

Nursing care complexity significantly influences medical complexity in hospitalized children. Understanding this link is crucial for improving pediatric patient care and outcomes.

Area of Science:

  • Pediatric healthcare research
  • Nursing science
  • Health services management

Background:

  • Hospitalized children present complex medical and nursing care needs.
  • The relationship between medical complexity and nursing care complexity in pediatrics is not fully understood.
  • Accurate assessment of these complexities is vital for effective healthcare delivery.

Purpose of the Study:

  • To investigate the association between Diagnosis-Related Group (DRG) weight and nursing care complexity in pediatric inpatients.
  • To identify key factors determining medical complexity in hospitalized children.
  • To inform strategies for optimizing pediatric patient care.

Main Methods:

  • Retrospective analysis of 914 children (2-11 years) admitted in 2022.
  • Utilized Neonatal Pediatric Professional Assessment Instrument and Hospital Discharge Register data.
  • Measured medical complexity via DRG weight and nursing complexity via documented nursing diagnoses (NDs) and nursing actions (NAs).

Main Results:

  • Significant positive correlations found between NDs and NAs (rs = 0.507, p < 0.001).
  • DRG weight correlated positively with both ND frequency (rs = 0.232, p < 0.001) and NAs (rs = 0.184, p < 0.001).
  • Nursing actions, surgical DRG, scheduled admissions, and ND frequency significantly predicted DRG weight (R2 = 0.311).

Conclusions:

  • Nursing care complexity is a significant determinant of medical complexity (DRG weight) in hospitalized children.
  • Clinical and organizational factors also influence medical complexity.
  • An integrated approach considering both medical and nursing complexities is essential for enhancing pediatric care and outcomes.
Abstract

Keywords:
childrendiagnosis-related groupmedical complexitynursing complexity of carestandardized nursing terminologies

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