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Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
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Published on: June 20, 2020

Stratification by complexity of children with complex chronic conditions: a retrospective study

Dorleta López de Suso Martínez de Aguirre1, Carlos Martín Gómez2, Iñigo de Noriega Echevarría3

  • 1Unidad de Cuidados Paliativos Pediátricos Integrales, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Fundación Para la Investigación Biomédica, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.

Anales De Pediatria
|June 10, 2026
PubMed

Insights

Identifying paediatric chronic complex conditions (PCCCs) requires more than just diagnosis. Combining tools like the Pediatric Medical Complexity Algorithm (PMCA) and PedCom scale improves assessment for better healthcare planning.

Area of Science:

  • Pediatric healthcare research
  • Medical complexity assessment
  • Chronic disease management

Background:

  • Increased survival of children with chronic diseases leads to a growing population of paediatric chronic complex conditions (PCCCs).
  • Inconsistent terminology and identification tools hinder effective patient stratification and healthcare resource planning for PCCCs.

Purpose of the Study:

  • To evaluate the complexity of pediatric patients with chronic conditions using validated assessment tools.
  • To compare the efficacy of the Pediatric Medical Complexity Algorithm (PMCA) and the PedCom scale in identifying PCCCs.

Main Methods:

  • Retrospective cross-sectional study of 355 pediatric patients from Madrid's administrative records (2023).
  • Sequential application of the Pediatric Medical Complexity Algorithm (PMCA) followed by the PedCom scale for complexity assessment.
  • Analysis of sociodemographic variables, primary diagnosis (ICD-10), and variation in complexity scores.

Main Results:

  • 66.2% of patients were identified as PCCCs by the PMCA.
  • Only 49.3% of PMCA-identified PCCCs met the criteria using the PedCom scale, indicating significant discrepancies.
  • Substantial variation in PedCom scores was observed among patients with the same primary diagnosis.

Conclusions:

  • Pediatric chronic condition complexity is influenced by multiple clinical and psychosocial factors, not solely the primary diagnosis.
  • Combined use of PMCA and PedCom scales can enhance the identification of complex pediatric cases.
  • Improved identification supports more tailored healthcare planning for children with chronic conditions.
Abstract

Keywords:
Chronic diseaseEnfermedad crónica complejaEstratificaciónHealth care needs and demandPalliative carePatient complexityPediatricsPediatríaServicios sociales

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