The National Landscape of Hospitalizations for Children With Medical Complexity

Area of Science:

• Pediatric Health Services Research
• Healthcare Economics
• Clinical Outcomes Analysis

Background:

• Children with medical complexity (CMC) represent a growing patient group with elevated risks of adverse healthcare events during hospitalization.
• Understanding resource utilization is crucial for managing this vulnerable population.

Purpose of the Study:

• To compare hospitalization resource use, including length of stay, costs, and mortality, between CMC and non-CMC patients.
• To analyze these differences based on the number of complex chronic conditions (CCCs) in CMC patients.

Main Methods:

• Utilized the 2022 Kids' Inpatient Database, a nationally representative dataset.
• Identified CMC patients by the presence of at least one complex chronic condition (CCC).
• Grouped CMC patients into categories: 1 CCC, 2 CCCs, or 3 or more CCCs, comparing them to non-CMC patients.

Main Results:

• CMC patients experienced significantly higher in-hospital mortality rates across all CCC groups compared to non-CMC.
• Hospital length of stay was substantially longer for CMC patients, increasing with the number of CCCs.
• Hospitalization costs were markedly higher for CMC patients, with costs escalating significantly with more complex conditions.

Conclusions:

• CMC patients exhibit significantly higher health services utilization and in-hospital mortality compared to non-CMC.
• Findings support the need for cost-effectiveness analyses of targeted interventions for CMC.
• Results can inform policy advocacy to reduce hospital- and individual-level inequities for CMC.