Evidence map›Paper›PMID 25489039›Full record

ArticleHealth affairs (Project Hope)2014

Children with medical complexity and Medicaid: spending and cost savings.

Jay G Berry, Matt Hall, John Neff, Denise Goodman, Eyal Cohen, Rishi Agrawal, Dennis Kuo, Chris Feudtner

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Health affairs (Project Hope), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 137 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
137citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

137 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Efficacy of a Resourcefulness Intervention to Enhance the Physical and Mental Health of Parents Caring for Technology-dependent Children at Home: A Randomized Controlled Trial.Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
    Trial
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  11. Observational
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  15. Kidney care at NICU discharge and follow-up recommendations for preterm infants<34 weeks.Journal of perinatology : official journal of the California Perinatal Association · 2026
    Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. National Economic Burden of Pediatric Asthma Hospitalizations.Annals of the American Thoracic Society · 2025
    Article

77 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Jay G BerryJay G. Berry (jay.berry@childrens.harvard.edu) is an assistant professor of pediatrics in the Department of Medicine and Division of General Pediatrics, Boston Children's Hospital and Harvard Medical School, in Massachusetts.
Matt HallMatt Hall is a senior statistician at the Children's Hospital Association, in Overland Park, Kansas.
John NeffJohn Neff is a professor of pediatrics at the University of Washington and Seattle Children's Hospital.
Denise GoodmanDenise Goodman is a professor of pediatrics at the Feinberg School of Medicine, Northwestern University, and the Ann and Robert H. Lurie Children's Hospital, in Chicago, Illinois.
Eyal CohenEyal Cohen is an associate professor of pediatrics at the University of Toronto and the Hospital for Sick Children, in Ontario.
Rishi AgrawalRishi Agrawal is an assistant professor of pediatrics at the Feinberg School of Medicine, Northwestern University, and the Ann and Robert H. Lurie Children's Hospital.
Dennis KuoDennis Kuo is an associate professor of pediatrics at the University of Arkansas for Medical Sciences and Arkansas Children's Hospital, both in Little Rock.
Chris FeudtnerChris Feudtner is a professor of pediatrics in the Division of General Pediatrics, PolicyLab, and Department of Medical Ethics at the University of Pennsylvania and the Children's Hospital of Philadelphia, in Pennsylvania.

Funding

Improving Healthcare Integration for Children with TracheostomyK23HD058092 · NICHD · BOSTON CHILDREN'S HOSPITAL · PI BERRY, JAY GRIFFIN · 2009 to 2013
$661k
Innovative Research Methods to Study Children with Multiple Chronic ConditionsR21HS023092 · AHRQ · BOSTON CHILDREN'S HOSPITAL · PI BERRY, JAY GRIFFIN · 2014 to 2014
$180k
AHRQ HHS R21 HS023092NICHD NIH HHS K23 HD058092
6 · The paper itself

Abstract

A small but growing population of children with medical complexity, many of whom are covered by Medicaid, accounts for a high proportion of pediatric health care spending. We first describe the expenditures for children with medical complexity insured by Medicaid across the care continuum. We report the increasingly large amount of spending on hospital care for these children, relative to the small amount of primary care and home care spending. We then present a business case that estimates how cost savings might be achieved for children with medical complexity from potential reductions in hospital and emergency department use and shows how the savings could underwrite investments in outpatient and community care. We conclude by discussing the importance of these findings in the context of Medicaid's quality of care and health care reform.

Indexed as

ChildChild Health ServicesCost SavingsEmergency Service, HospitalHealth Care CostsHospital CostsHumansLength of StayMedicaidPatient ReadmissionRetrospective StudiesUnited StatesChildren’s HealthChronic CareHealth SpendingMedicaidOrganization and Delivery of Care

Identifiers

PMID25489039
PMCPMC5164920

What OpenQuestion holds

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Registered trials

None linked

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.