Related Experiment Video
Updated: Jan 8, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
The National Landscape of Hospitalizations for Children With Medical Complexity
Jonathan M Gabbay1, James R Barnett1, Benjamin V M Bajaj2
1Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York.
Insights
Children with medical complexity (CMC) face higher hospitalization risks, including increased mortality, longer stays, and greater costs compared to non-CMC. These findings highlight inequities and inform targeted interventions.
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.
Background:
Children with medical complexity (CMC) are an evolving patient population at high risk of adverse health care outcomes while hospitalized.
Objective:
Using a nationally representative cohort, we aimed to compare hospitalization resource use for CMC to non-CMC.
Methods:
Using the 2022 Kids' Inpatient Database, we identified CMC by the presence of at least 1 complex chronic condition (CCCs) and grouped CMC by 1, 2, or 3 or more CCC. The outcomes were length of stay, hospitalization costs, and in-hospital mortality across CMC groupings compared with non-CMC.
Results:
Of 3 169 944 pediatric hospitalizations in the United States, 389 127 (12.3%), 118 257 (3.7%), and 155 196 (4.9%) had 1 CCC, 2 CCC, and 3 or more CCC, respectively. Relative to non-CMC, each CMC group had significantly higher odds of in-hospital mortality (1 CCC: adjusted odds ratio [aOR] 31.3 [29.0, 33.7], P < .001; 2 CCC: aOR 53.5 [49.1, 58.2], P < .001; 3+ CCC: aOR 66.9 [61.1, 73.4], P < .001), longer length of stay in days (1 CCC: +3.20, [2.95, 3.44], P < .001; 2 CCC: +6.50, [5.97, 7.02], P < .001; 3+ CCC: +11.6 [10.8, 12.4], P < .001), and higher hospitalization costs (1 CCC: +$13 388 [11 947, 14 829], P < .001; 2 CCC: +$29 426 [26 233, 32 619], P < .001; 3+ CCC: +$57 426 [51 272, 63 580], P < .001).
Conclusions:
We highlight substantial health services use and in-hospital mortality for CMC compared with non-CMC. Health systems can use our findings to analyze cost-effectiveness of targeted interventions for CMC, as well as advocate for policy-based changes to reduce hospital- and individual-level inequities for CMC.
Related Concept Videos
00:59Hospitals-II
Nurses that work in...
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...
01:30Specialized 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...
01:28Hospitals-I
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:21Tertiary Healthcare System