ArticleEuropean journal of pediatrics2026
Identification and characteristics of children with complex chronic diseases in the paediatric ward of a tertiary hospital: a prospective study.
Article in European journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Children with chronic and complex conditions (CCCC) are a population with a growing impact on healthcare. Several methods for their identification have been developed, but their performance requires further research. Our objective was to characterize hospitalizations due to CCCC and to compare two methods for identifying these patients on a hospital ward: one that requires a direct interview with the parents/caregivers (PedCom scale), and another based on clinical records (Parente algorithm). A prospective study was conducted over one year, including all children hospitalized > 24 h in a pediatric ward of a Spanish tertiary hospital. Children with special health needs (CSHN) were identified using a specific tool, the Children with Special Health Care Needs Screener, and among them, CCCC were identified by expert consensus. The performance and agreement of PedCom scale and Parente algorithm for identifying CCCC were compared. CSHN were identified in 22.7% of hospitalizations, and 23.3% of them were CCCC. CCCC accounted for 9.0% of all hospitalizations, and 13.3% of total hospital days. CCCC required longer hospital stays, more diagnostic and therapeutic procedures, and were more frequently transferred to other centers with a higher level of care, compared to CSHN no-CCCC. For the identification of CCCC, PedCom showed greater sensitivity (84.6%; 95%CI: 66.5-93.9) than Parente (34.6%; 95%CI: 19.4-53.8), with high specificity for both tools: 95.8% (95%CI: 88.3-98.6) and 100% (95%CI: 94.9-100.0), respectively. Agreement between PedCom and Parente was low-to-moderate (kappa 0.455; 95% CI: 0.211-0.699).
conclusionsA high proportion of pediatric hospitalizations correspond to CCCC, with a greater consumption of healthcare resources. The PedCom scale performs much better in identifying CCCC than Parente's algorithm. WHAT IS KNOWN: • The increasing prevalence of children with chronic and complex conditions (CCCC) poses a challenge to healthcare systems. Identifying these children is a key step in organizing health services. WHAT IS NEW: • The PedCom scale has suitable characteristics for identifying hospitalized CCCC, and has a superior performance to the Parente algorithm.
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