Variation in Child Health Care Utilization by Medical Complexity

Children with medical complexity (CMC) have multiple specialty need, technology dependence, and high health care utilization. The objective of this study is to profile types of pediatric health care utilization and costs by increasing levels of medical complexity. This is a cross-sectional study of...

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Bibliographic Details
Published in:Maternal and child health journal 2015-01, Vol.19 (1), p.40-48
Main Authors: Kuo, Dennis Z., Melguizo-Castro, Maria, Goudie, Anthony, Nick, Todd G., Robbins, James M., Casey, Patrick H.
Format: Article
Language:English
Subjects:
Adolescent
Analysis
Care and treatment
Child
Child health
Child Health Services - economics
Child Health Services - statistics & numerical data
Child, Preschool
Children & youth
Childrens health
Chronic Disease - economics
Chronic Disease - epidemiology
Chronic Disease - therapy
Chronic diseases
Communicable Diseases - epidemiology
Complex patients
Cross-Sectional Studies
Datasets
Disabled Children - statistics & numerical data
Emergency medical care
Emergency Service, Hospital - economics
Emergency Service, Hospital - statistics & numerical data
Female
Gynecology
Health care disparities
Health care expenditures
Health care policy
Health services utilization
Hospitalization - economics
Hospitalization - statistics & numerical data
Hospitals
Humans
Infant
Infant, Newborn
Male
Maternal and Child Health
Medicine
Medicine & Public Health
Mental disorders
Mental health
Outpatients - statistics & numerical data
Pediatrics
Population Economics
Professional-Family Relations
Public Health
Sex Distribution
Sociology
United States - epidemiology
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Description
Summary:Children with medical complexity (CMC) have multiple specialty need, technology dependence, and high health care utilization. The objective of this study is to profile types of pediatric health care utilization and costs by increasing levels of medical complexity. This is a cross-sectional study of the 2007, 2008 and 2009 Full-Year Data Sets from the Medical Expenditure Panel Survey. Medical complexity was defined by a higher number of positive items from the five question children with special health care needs (CSHCN) Screener. CMC were defined by ≥4 positive screener items. Outcomes included the number of inpatient, outpatient, and emergency department visits, associated costs and diagnoses, and reported satisfaction. ICD-9 codes were grouped by Clinical Classifications Software. Of 27,755 total study subjects ≤17 years, 4,851 had special needs and 541 were CMC. Older age, male gender, white/non-Hispanic race/ethnicity, and public insurance were all associated with medical complexity (all p  
ISSN:1092-7875
1573-6628
DOI:10.1007/s10995-014-1493-0