Related Experiment Video
Updated: Jan 6, 2026
Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
Social Needs of Children With Medical Complexity and Inpatient Care Utilization
Lauren Ondrejka1, Edith Allen1, Wendy Arafiles1,2
1University of Arizona College of Medicine-Phoenix, Phoenix, Arizona.
Insights
Children with medical complexity (CMC) facing social needs challenges experience higher hospital readmission rates and longer hospital stays. Addressing these social determinants of health is crucial for improving outcomes and reducing healthcare utilization for CMC.
Area of Science:
- Pediatric Healthcare
- Social Determinants of Health
- Health Services Research
Background:
- Children with medical complexity (CMC) often have unmet social needs that can impact their health outcomes.
- Social needs screening is increasingly used to identify these challenges in pediatric populations.
- Understanding the link between social needs and healthcare utilization is vital for resource allocation and patient support.
Purpose of the Study:
- To determine if CMC with positive social needs screens exhibit higher readmission rates and longer lengths of stay (LOS).
- To quantify the association between identified social needs and hospital utilization metrics in CMC.
- To provide evidence for targeted interventions supporting CMC with social needs.
Main Methods:
- A retrospective cohort study analyzed CMC aged 0-21 years admitted to a tertiary children's hospital.
- Patients with at least three subspecialists and medical technology use were included.
- Social needs were assessed via caregiver surveys, with positive screens indicating at least one reported need. Readmission rates and LOS were compared between groups.
Main Results:
- Four hundred eighty-four CMC were included: 129 with positive screens and 355 with negative screens.
- CMC with positive screens showed a significantly higher 30-day readmission rate (36% vs 26%) and longer LOS (6 days longer).
- Demographics differed, with higher representation of Black/African American and Hispanic/Latinx patients in the positive screen group.
Conclusions:
- Positive social needs screens in CMC are associated with significantly increased hospital utilization, including higher readmission rates and longer hospital stays.
- These findings underscore the critical impact of social needs on the healthcare burden of CMC.
- Interventions addressing social determinants of health are essential for optimizing care and reducing hospital resource use for this vulnerable population.
Objective:
Determine whether children with medical complexity (CMC) with positive social needs screens have more readmissions and longer length of stay (LOS).
Methods:
Retrospective cohort study of CMC aged 0 to 21 years admitted to a tertiary care children's hospital from October 1, 2022, to September 30, 2023. Inclusion required at least 3 subspecialists and medical technology use. Caregivers received a link to the questionnaire via text message. Surveys with at least 1 need reported were deemed positive. Thirty-day readmission rates (RRs), total hospital days, and LOS were compared between CMC with and without a positive screen. Analysis included Mann-Whitney test, χ2/Fisher exact test, mixed-effects model for LOS, and multivariable logistic regression for 30-day RR. All P values are 2-sided; P < .05 is considered statistically significant.
Results:
Five hundred eighty-three medical records were reviewed; 99 were excluded. Four hundred eighty-four patients remained: 129 positive screens and 355 negative screens. Demographics between groups differed only by race and ethnicity, with more Black/African American and Hispanic/Latinx patients represented in the positive screen group (12.4% vs 7.9%; 45% vs 33.5%; P = .008). CMC with positive screens had a significantly higher 30-day RR (0.36 vs 0.26; odds ratio, 1.56; 95% CI, 1.01-2.40; P = .04) and longer LOS (β = 6; 95% CI, 1-10; P = .01) even after adjusting for potential confounders. They also had more total hospital days (median, 13; IQR, 3-42 vs median, 8; IQR, 3-24), but the difference was not statistically significant (P = .06).
Conclusion:
CMC with social needs had significantly higher hospital utilization with more 30-day readmissions and longer hospital stays, trending toward increased hospital days. These findings highlight the impact of social needs on CMC and can inform future interventions to support patients and reduce hospital utilization.
Related Concept Videos
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:19Restorative Care