Tricks of the trade: Assessment of high-tech gear in special needs children

Teoh, Doreen

doi:10.1016/s1522-8401(02)90018-2

Cited by 5 publications

(2 citation statements)

References 50 publications

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“…We examined both proportions and total numbers of pediatric hospital admissions, length of stay (LOS), total charges, technology-assistance procedures,5,17 and mortality 13. Technology-assistance procedures were defined by using ICD-9-CM procedure codes for gastrostomy (43.1), permanent tracheostomy (31.2×), and extracranial ventricular shunt (02.3×).…”

Section: Methodsmentioning

confidence: 99%

Children With Complex Chronic Conditions in Inpatient Hospital Settings in the United States

Simon¹,

et al. 2010

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OBJECTIVES Hospitalized children are perceived to be increasingly medically complex, but no such trend has been documented. The objective of this study was to determine whether the proportion of pediatric inpatient use that is attributable to patients with a diagnosis of one or more complex chronic condition (CCC) has increased over time and to assess the degree to which CCC hospitalizations are associated with attributes that are consistent with heightened medical complexity. METHODS A retrospective observational study that used the 1997, 2000, 2003, and 2006 Kids Inpatient Databases examined US hospitalizations for children. Attributes of medical complexity included hospital admissions, length of stay, total charges, technology-assistance procedures, and mortality risk. RESULTS The proportion of inpatient pediatric admissions, days, and charges increased from 1997 to 2006 for any CCC and for every CCC group except hematology. CCCs accounted for 8.9% of US pediatric admissions in 1997 and 10.1% of admissions in 2006. These admissions used 22.7% to 26.1% of pediatric hospital days, used 37.1% to 40.6% of pediatric hospital charges, accounted for 41.9% to 43.2% of deaths, and (for 2006) used 73% to 92% of different forms of technology-assistance procedures. As the number of CCCs for a given admission increased, all markers of use increased. CONCLUSIONS CCC-associated hospitalizations compose an increasing proportion of inpatient care and resource use. Future research should seek to improve methods to identify the population of medically complex children, monitor their increasing inpatient use, and assess whether current systems of care are meeting their needs.

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Section: Methodsmentioning

confidence: 99%

Children With Complex Chronic Conditions in Inpatient Hospital Settings in the United States

Simon¹,

et al. 2010

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“…We examined both proportions and total numbers of pediatric hospital admissions, length of stay (LOS), total charges, technology-assistance procedures, 5,17 and mortality. 13 Technologyassistance procedures were defined by using ICD-9-CM procedure codes for gastrostomy (43.1), permanent tracheostomy (31.2×), and extracranial ventricular shunt (02.3×).…”

Section: Measured Attributes Of Medical Complexitymentioning

confidence: 99%

Children With Complex Chronic Conditions in Inpatient Hospital Settings in the United States

2010

PEDIATRICS

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OBJECTIVES-Hospitalized children are perceived to be increasingly medically complex, but no such trend has been documented. The objective of this study was to determine whether the proportion of pediatric inpatient use that is attributable to patients with a diagnosis of one or more complex chronic condition (CCC) has increased over time and to assess the degree to which CCC hospitalizations are associated with attributes that are consistent with heightened medical complexity.METHODS-A retrospective observational study that used the 1997, 2000, 2003, and 2006 Kids Inpatient Databases examined US hospitalizations for children. Attributes of medical complexity included hospital admissions, length of stay, total charges, technology-assistance procedures, and mortality risk. RESULTS-The proportion of inpatient pediatric admissions, days, and charges increased from 1997 to 2006 for any CCC and for every CCC group except hematology. CCCs accounted for 8.9% of US pediatric admissions in 1997 and 10.1% of admissions in 2006. These admissions used 22.7% to 26.1% of pediatric hospital days, used 37.1% to 40.6% of pediatric hospital charges, accounted for 41.9% to 43.2% of deaths, and (for 2006) used 73% to 92% of different forms of technologyassistance procedures. As the number of CCCs for a given admission increased, all markers of use increased.CONCLUSIONS-CCC-associated hospitalizations compose an increasing proportion of inpatient care and resource use. Future research should seek to improve methods to identify the population of medically complex children, monitor their increasing inpatient use, and assess whether current systems of care are meeting their needs. NIH Public Access Author ManuscriptPediatrics. Author manuscript; available in PMC 2010 October 22. Chronic illness accounts for the majority of children's hospital days and dollars. 4 A smaller set of CSHCN, termed medically complex children, are perceived to use a disproportionate amount of resources, particularly in the inpatient and tertiary care settings. 5 Consistent and complete identification criteria of this subpopulation for administrative, clinical, and research purposes, however, remains elusive. 5-7 A prototypical medically complex child has a diversity of conditions and multisystem disease; may be technology-dependent; has frequent inpatient admissions; and requires multiple medications, multiple subspecialists, and optimal care coordination across inpatient and outpatient settings. 5 Previous work describing the 6.5% of children with disabilities, 8,9 the nearly 5% of children with multiple chronic conditions, 10 or children with technology dependence 5 likely described sets of children with some degree of medical complexity.For accurate attribution of health care use of medically complex children, an operational definition is needed for use in administrative data sets. One potential method to study medically complex children is to group International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes so...

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Vomiting, Spitting Up, and Feeding Disorders

McDevitt¹

2008

Pediatric Emergency Medicine

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Tricks of the trade: Assessment of high-tech gear in special needs children

Cited by 5 publications

References 50 publications

Children With Complex Chronic Conditions in Inpatient Hospital Settings in the United States

Children With Complex Chronic Conditions in Inpatient Hospital Settings in the United States

Children With Complex Chronic Conditions in Inpatient Hospital Settings in the United States

Vomiting, Spitting Up, and Feeding Disorders

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