Hospitalizations by Children With Medical Complexity From 2009 to 2022

作者：JoAnna K. Leyenaar, Seneca D. Freyleue, Mary Arakelyan, Andrew Schaefer · 发表于：PEDIATRICS · 年份：2025 · DOI：10.1542/peds.2025-071774 · 被引用次数：20 · 研究领域：Healthcare Policy and Management、Chronic Disease Management Strategies、Primary Care and Health Outcomes

BACKGROUND AND OBJECTIVES: Children with medical complexity (CMC) have multifaceted health care needs and are more likely to be hospitalized than children without medical complexity. This study examined the number and proportion of hospitalizations experienced by CMC in the United States from 2009 to 2022 and describes hospitalization characteristics. METHODS: This retrospective repeated cross-sectional study analyzed the Kids' Inpatient Database in 2009, 2012, 2016, 2019, and 2022. CMC were identified using the Complex Chronic Condition Classification System and Pediatric Medical Complexity Algorithm. Survey weights were applied to generate national estimates of the number and proportion of nonbirth hospitalizations in children aged less than 18 years experienced by CMC each year, as well as the number and proportion of hospital days, in-hospital deaths, and costs incurred by CMC overall and at freestanding children's hospitals and general hospitals. RESULTS: CMC experienced an estimated 1.14 million hospitalizations in 2009 and 1.02 million in 2022. In 2022, 37.8% (n = 386 961) of CMC-associated hospitalizations were at freestanding children's hospitals, and 62.2% (n = 636 789) were at general hospitals. These hospitalizations represented 49.0% (95% CI, 47.8%-50.3%) of pediatric hospitalizations in 2009 and 62.8% (95% CI, 61.7%-64.0%) in 2022. In 2022, CMC-associated hospitalizations accounted for 79.2% (95% CI, 76.8%-81.5%) of hospital days (n = 7.36 million days), 92.6% (...