ArticlePediatrics2013
Medical complexity and pediatric emergency department and inpatient utilization.
Article in Pediatrics, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Hospital-to-home transitions for children with medical complexity: part 1, a systematic review of reported outcomes.European journal of pediatrics · 2023Pooled it
- Improving transitions in care for children with complex and medically fragile needs: a mixed methods study.BMC pediatrics · 2020Trial
- Effects of a Telehealth Care Coordination Intervention on Perceptions of Health Care by Caregivers of Children With Medical Complexity: A Randomized Controlled Trial.Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & PractitionersTrial
- Talk to Me, Not Just My Parent: Teen and Caregiver Perspectives on Implementing Screening, Brief Intervention, and Referral to Treatment Equitably in Pediatric Inpatient Settings for Teens with Chronic Illness.Children (Basel, Switzerland) · 2026Article
- Changes in Academic Standardized Testing After Pediatric Intensive Care.JAMA network open · 2026Article
- Canadian paediatric tertiary care hospitals' response to the needs of children with medical complexity during acute visits and hospitalisations: A landscape study.Paediatrics & child health · 2025Article
- Identification and stratification tools for children with chronic pathology and complexity: systematic scoping review.European journal of pediatrics · 2025Article
- Implementation of Emergency Information Forms and Impact on Health Outcomes: A Long Time Coming.Hospital pediatrics · 2025Article
- Setting Up for Success: Caregiver Perspectives on Emergency Care Plans for Children With Medical Complexity.Pediatric emergency care · 2025Article
- Predictors of high-acuity outcomes among 10-17-year-olds utilizing pediatric emergency services in Taiwan: a sex-based comparison of male and female adolescents.BMC emergency medicine · 2025Article
- High-Risk Infant Developmental Outcome Is Associated with Medical Complexity and Neighborhood Opportunity.The Journal of pediatrics · 2025Article
- Family-based substance use screening and intervention for adolescents with chronic medical conditions: a study protocol to implement SBIRT-family within school-based health centers.Frontiers in health services · 2025Article
- Experiences of Inpatient Healthcare Services Among Children With Medical Complexity and Their Families: A Scoping Review.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- National Characteristics of Emergency Care for Children with Neurologic Complex Chronic Conditions.The western journal of emergency medicine · 2024Article
- Health care transition quadruple aim outcomes for IDD: Scoping review.Health care transitions · 2024Article
- Guideline-Adherent Hypertension in Children and Adolescents: A Multi-Institutional Database Analysis from Taiwan.Journal of clinical medicine · 2023Article
- Comparing two definitions of pediatric complexity among children cared for in general and pediatric emergency departments in a statewide sample.Journal of the American College of Emergency Physicians open · 2023Article
- Implementation and Evaluation of a Wraparound Virtual Care Program for Children with Medical Complexity.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2023Article
- A retrospective cohort analysis of the Yale pediatric genomics discovery program.American journal of medical genetics. Part A · 2022Article
- Febrile children with comorbidities at the emergency department - a multicentre observational study.European journal of pediatrics · 2022Observational
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivesTo characterize the use of and disposition from a tertiary pediatric emergency department (PED) by children with chronic conditions with varying degrees of medical complexity.
methodsWe conducted a retrospective cohort study using a dataset of all registered PED patient visits at Seattle Children's Hospital from January 1, 2008, through December 31, 2009. Children's medical complexity was classified by using a validated algorithm (Clinical Risk Group software) into nonchronic and chronic conditions: episodic chronic, lifelong chronic, progressive chronic, and malignancy. Outcomes included PED length of stay (LOS) and disposition. Logistic regression generated age-adjusted odds ratios (AOR) of admission with 95% confidence intervals (CIs).
resultsPED visits totaled 77 748; 20% (15 433) of which were for children with chronic conditions. Compared with visits for children without chronic conditions, those for children with chronic conditions had increased PED LOS (on average, 79 minutes longer; 95% CI 77-81; P < .0001) and hospital (51% vs 10%) and PICU (3.2% vs 0.1%) admission rates (AOR 10.3, 95% CI 9.9-10.7 to hospital and AOR 25.0, 95% CI 17.0-36.0 to PICU). Admission rates and PED LOS increased with increasing medical complexity.
conclusionsChildren with chronic conditions comprise a significant portion of annual PED visits in a tertiary pediatric center; medical complexity is associated with increased PED LOS and hospital or PICU admission. Clinical Risk Group may have utility in identifying high utilizers of PED resources and help support the development of interventions to facilitate optimal PED management, such as pre-arrival identification and individual emergency care plans.
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Registered trials
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