{"id":5106,"date":"2012-11-26T00:00:00","date_gmt":"2012-11-26T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\/"},"modified":"2023-06-14T20:13:42","modified_gmt":"2023-06-15T00:13:42","slug":"patterns-and-costs-of-health-care-use-of-children-with-medical-complexity","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\/","title":{"rendered":"Patterns and costs of healthcare use of children with medical complexity"},"content":{"rendered":"

Background and Objective<\/span> — Healthcare use of children with medical complexity (CMC), such as those with neurologic impairment or other complex chronic conditions (CCCs) and those with technology assistance (TA), is not well understood. The objective of the study was to evaluate healthcare utilization and costs in a population-based sample of CMC in Ontario, Canada.<\/p>\n

Methods<\/strong> — Hospital discharge data from 2005 through 2007 identified CMC. Complete health system use and costs were analyzed over the subsequent 2-year period.<\/p>\n

Results<\/strong> — The study identified 15 771 hospitalized CMC (0.67% of children in Ontario); 10 340 (65.6%) had single-organ CCC, 1063 (6.7%) multiorgan CCC, 4368 (27.6%) neurologic impairment, and 1863 (11.8%) had TA. CMC saw a median of 13 outpatient physicians and 6 distinct subspecialists. Thirty-six percent received home care services. Thirty-day readmission varied from 12.6% (single CCC without TA) to 23.7% (multiple CCC with TA). CMC accounted for almost one-third of child health spending. Rehospitalization accounted for the largest proportion of subsequent costs (27.2%), followed by home care (11.3%) and physician services (6.0%). Home care costs were a much larger proportion of costs in children with TA. Children with multiple CCC with TA had costs 3.5 times higher than children with a single CCC without TA.<\/p>\n

Conclusions<\/strong> — Although a small proportion of the population, CMC account for a substantial proportion of healthcare costs. CMC make multiple transitions across providers and care settings and CMC with TA have higher costs and home care use. Initiatives to improve their health outcomes and decrease costs need to focus on the entire continuum of care<\/p>\n","protected":false},"excerpt":{"rendered":"

Background and Objective — Healthcare use of children with medical complexity (CMC), such as those with neurologic impairment or other complex chronic conditions (CCCs) and those with technology assistance (TA), is not well understood. The objective of the study was to evaluate healthcare utilization and costs in a population-based sample of CMC in Ontario, Canada. […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[62,27],"migration-helper-qa-sample-set":[],"class_list":["post-5106","journal_article","type-journal_article","status-publish","hentry","topic-health-services-research","topic-pediatrics"],"acf":{"citation":"Cohen E, Berry JG, Camacho X, Anderson G, Wodchis W, Guttmann A. Pediatrics<\/em>. 2012; 130(6):e1463-70. Epub 2012 Nov 26.","source_url":"http:\/\/pediatrics.aappublications.org\/content\/130\/6\/e1463.long","ices_scientist":[1199,1382,1135,1238],"site":[6735,6733],"research_program":[6740],"news_release":[7465],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"4DB2CB30-5B7F-48F2-8EEA-FCA3A586F13D","sitecore_item_name":"Patterns-and-costs-of-health-care-use-of-children-with-medical-complexity","sitecore_field_values":"{\n \"Title\": \"Patterns and costs of healthcare use of children with medical complexity\",\n \"Short title\": \"Patterns and costs of healthcare use\",\n \"Citation\": \"

Cohen E, Berry JG, Camacho X, Anderson G, Wodchis W, Guttmann A. Pediatrics<\/em>. 2012; 130(6):e1463-70. Epub 2012 Nov 26.<\/p>\",\n \"Abstract\": \"

Background and Objective<\/span> — Healthcare use of children with medical complexity (CMC), such as those with neurologic impairment or other complex chronic conditions (CCCs) and those with technology assistance (TA), is not well understood. The objective of the study was to evaluate healthcare utilization and costs in a population-based sample of CMC in Ontario, Canada.<\/p>n

Methods<\/strong> — Hospital discharge data from 2005 through 2007 identified CMC. Complete health system use and costs were analyzed over the subsequent 2-year period.<\/p>n

Results<\/strong> — The study identified 15 771 hospitalized CMC (0.67% of children in Ontario); 10 340 (65.6%) had single-organ CCC, 1063 (6.7%) multiorgan CCC, 4368 (27.6%) neurologic impairment, and 1863 (11.8%) had TA. CMC saw a median of 13 outpatient physicians and 6 distinct subspecialists. Thirty-six percent received home care services. Thirty-day readmission varied from 12.6% (single CCC without TA) to 23.7% (multiple CCC with TA). CMC accounted for almost one-third of child health spending. Rehospitalization accounted for the largest proportion of subsequent costs (27.2%), followed by home care (11.3%) and physician services (6.0%). Home care costs were a much larger proportion of costs in children with TA. Children with multiple CCC with TA had costs 3.5 times higher than children with a single CCC without TA.<\/p>n

Conclusions<\/strong> — Although a small proportion of the population, CMC account for a substantial proportion of healthcare costs. CMC make multiple transitions across providers and care settings and CMC with TA have higher costs and home care use. Initiatives to improve their health outcomes and decrease costs need to focus on the entire continuum of care<\/p>n

View full text<\/a><\/p>\",\n \"Keywords\": \"{002C9B1A-B097-4316-A26A-BA3C0A3B8FA9}|{3520E276-FC47-4BE8-BC0D-5FD075E6DBEF}\",\n \"Related Products\": \"

News Release<\/h2>rn

Initiatives needed to improve health outcomes and decrease costs for children with medical complexity<\/a><\/h3>\",\n \"Research Programs\": \"{46DF28D2-EDE8-4DF2-8CC0-87CEF464E435}\",\n \"ICES Locations\": \"{FBE2D1B1-C0BA-423F-8D16-39466B6C1424}|{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n \"ICES Scientists\": \"{146BBAFD-AD87-4D94-BCFF-79AB2D157CF9}|{38899D1B-38E7-4517-8DA3-0BDDF1F9944D}|{26C6C411-14DA-4E2F-9D10-9564115ADE0A}|{DF9D6D4F-1B33-4FB9-AD9B-576798163C2C}\",\n \"Posted Date\": \"20121126T000000\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2012\/January\/Patterns-and-costs-of-health-care-use-of-children-with-medical-complexity"},"yoast_head":"\nICES | Patterns and costs of healthcare use of children with medical complexity<\/title>\n<meta name=\"description\" content=\"Background and Objective — Healthcare use of children with medical complexity (CMC), such as those with neurologic impairment or other complex\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | Patterns and costs of healthcare use of children with medical complexity\" \/>\n<meta property=\"og:description\" content=\"Background and Objective — Healthcare use of children with medical complexity (CMC), such as those with neurologic impairment or other complex\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-15T00:13:42+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\\\/\",\"name\":\"ICES | Patterns and costs of healthcare use of children with medical complexity\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2012-11-26T05:00:00+00:00\",\"dateModified\":\"2023-06-15T00:13:42+00:00\",\"description\":\"Background and Objective — Healthcare use of children with medical complexity (CMC), such as those with neurologic impairment or other complex\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Journal Articles\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Patterns and costs of healthcare use of children with medical complexity\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"name\":\"ICES\",\"description\":\"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\"},\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\",\"name\":\"ICES\",\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"contentUrl\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"width\":\"676\",\"height\":\"618\",\"caption\":\"ICES\"},\"image\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/ICESOntario\\\/\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/ices-research-institute\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ICES | Patterns and costs of healthcare use of children with medical complexity","description":"Background and Objective — Healthcare use of children with medical complexity (CMC), such as those with neurologic impairment or other complex","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\/","og_locale":"fr_FR","og_type":"article","og_title":"ICES | Patterns and costs of healthcare use of children with medical complexity","og_description":"Background and Objective — Healthcare use of children with medical complexity (CMC), such as those with neurologic impairment or other complex","og_url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\/","og_site_name":"ICES","article_publisher":"https:\/\/www.facebook.com\/ICESOntario\/","article_modified_time":"2023-06-15T00:13:42+00:00","og_image":[{"width":1200,"height":675,"url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\/","url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\/","name":"ICES | Patterns and costs of healthcare use of children with medical complexity","isPartOf":{"@id":"https:\/\/www.ices.on.ca\/fr\/#website"},"datePublished":"2012-11-26T05:00:00+00:00","dateModified":"2023-06-15T00:13:42+00:00","description":"Background and Objective — Healthcare use of children with medical complexity (CMC), such as those with neurologic impairment or other complex","breadcrumb":{"@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/patterns-and-costs-of-health-care-use-of-children-with-medical-complexity\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ices.on.ca\/fr\/"},{"@type":"ListItem","position":2,"name":"Journal Articles","item":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/"},{"@type":"ListItem","position":3,"name":"Patterns and costs of healthcare use of children with medical complexity"}]},{"@type":"WebSite","@id":"https:\/\/www.ices.on.ca\/fr\/#website","url":"https:\/\/www.ices.on.ca\/fr\/","name":"ICES","description":"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE","publisher":{"@id":"https:\/\/www.ices.on.ca\/fr\/#organization"},"alternateName":"Institute for Clinical Evaluative Sciences","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ices.on.ca\/fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/www.ices.on.ca\/fr\/#organization","name":"ICES","alternateName":"Institute for Clinical Evaluative Sciences","url":"https:\/\/www.ices.on.ca\/fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/","url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","contentUrl":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","width":"676","height":"618","caption":"ICES"},"image":{"@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ICESOntario\/","https:\/\/www.linkedin.com\/company\/ices-research-institute\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article\/5106","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article"}],"about":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/types\/journal_article"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/news_release\/7465"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6740"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6733"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6735"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1238"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1135"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1382"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1199"}],"wp:attachment":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/media?parent=5106"}],"wp:term":[{"taxonomy":"migration-helper-automated","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-automated?post=5106"},{"taxonomy":"migration-manual","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-manual?post=5106"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/topic?post=5106"},{"taxonomy":"migration-helper-qa-sample-set","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-qa-sample-set?post=5106"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}