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.
Gabbay et al. (Fri,) studied this question.