ArticleMaternal and child health journal2015
Variation in child health care utilization by medical complexity.
Article in Maternal and child health journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.
What it found
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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
52 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- How are children with medical complexity being identified in epidemiological studies? A systematic review.World journal of pediatrics : WJP · 2023Pooled it
- Hospital-to-home transitions for children with medical complexity: part 1, a systematic review of reported outcomes.European journal of pediatrics · 2023Pooled it
- Parent SMART: Effects of residential treatment and an adjunctive parenting intervention on behavioral health services utilization.Journal of substance use and addiction treatment · 2024Trial
- Improving transitions in care for children with complex and medically fragile needs: a mixed methods study.BMC pediatrics · 2020Trial
- The Impact of Telehealth and Care Coordination on the Number and Type of Clinical Visits for Children With Medical Complexity.Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & PractitionersTrial
- Parent understanding and satisfaction with NICU discharge for infants with medical complexity: a scoping review of discharge instruction tools.BMC pediatrics · 2026Article
- Parent Understanding and Satisfaction with NICU Discharge for Infants with Medical Complexity: A Scoping Review of Discharge Instruction Tools.Research square · 2026Article
- Improved Respiratory Outcomes Following Multidisciplinary Aerodigestive Care in Medically Complex Children: A Longitudinal Single-Center Study.Pediatric pulmonology · 2026Article
- Moving from Challenge to Change: Redesigning Inpatient Care for Children with Complex Care Needs.Children (Basel, Switzerland) · 2026Article
- Application of a machine learning model to predict the estimated primary care patient time consumption.npj health systems · 2026Article
- Health professional perspectives on integrating substance use services into pediatric hospitals for adolescents with chronic medical conditions.Discover health systems · 2026Article
- Article
- 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
- Screening for Caregiver Stress in an Urban Medical Home for Children with Medical Complexity: Results of a Pilot Study.Children (Basel, Switzerland) · 2025Article
- Patterns of Medical Utilization in Children, Adolescents, and Young Adults With Life-Limiting Conditions in Korea: A Cohort Study Based on National Health Insurance Data.Journal of Korean medical science · 2025Article
- Autism and Medical Complexity Among Children in the United States.Pediatrics · 2025Article
- Pediatric complex chronic and life-limiting conditions in the Basque public health system: cross-sectional prevalence study.World journal of pediatrics : WJP · 2025Article
- Universal substance use care for adolescents with chronic medical conditions: a protocol to examine equitable implementation determinants and strategies for SBIRT at a pediatric hospital.Addiction science & clinical practice · 2024Article
- Utilization of Healthcare Services in Patients with Chronic Diseases under 18 Years Old: Differences and Contributing Factors.Journal of personalized medicine · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
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 < 0.001). CMC had an annual mean of 19 annual outpatient visits ($616) and 0.26 inpatient visits ($3,308), with other significant cost drivers including home health ($2,957) and prescriptions ($2,182). The most common reasons for non-CSHCN and less-complex CSHCN outpatient visits were viral illnesses, while the main reasons for CMC visits were for mental health. Compared to families without CSHCN, those with CMC have, on average, lower satisfaction with health care (8.4 vs. 8.9 out of 10, p < 0.001). Health care models for CMC should account for mental health conditions that may be driving high numbers of outpatient encounters.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.