U.S. children's hospitals treating more complex, expensive condi - New York News

U.S. children's hospitals treating more complex, expensive conditions

Posted: Updated:
By Alan Mozes
HealthDay Reporter

THURSDAY, Dec. 27 (HealthDay News) -- An in-depth profile of many U.S. children's hospitals suggests that children with complex chronic diseases such as cerebral palsy are taking up an increasingly larger share of hospital resources.

The finding raises concerns about how well freestanding pediatric hospitals can handle a rapidly growing group of patients that are, by definition, difficult and expensive to care for.

"Children with medical complexity are often relying on a myriad of services to get their health care needs met," said study lead author Dr. Jay Berry, an assistant professor of pediatrics with Boston Children's Hospital and Harvard Medical School in Boston. "These services include primary and specialty care, home nursing and case management."

Most children seen in hospitals are healthy overall, but require treatment for an acute sickness, such as pneumonia, the authors stressed. But a minority of children suffer from lifelong chronic sickness, such as those born with heart disease; neurological diseases such as cerebral palsy, which impairs muscle tone and movement; or Down syndrome, a chromosomal disorder that affects the nervous system and may include heart, hearing and skeletal problems.

It's not unusual for children with complex conditions to see 10 to 15 different care providers throughout the year, Berry said. "They tend to have a lot of appointments," he added.

Two main factors are driving up hospital use by children with medically complex conditions, he noted. "One, survival for these children has improved. They are living longer, but at the expense of developing secondary co-morbid conditions that often require hospital care for treatment," he said.

"Two, care coordination for these children is inadequate," he added. "With better care coordination and proactive care planning, we believe that the children would be healthier and not need to come into the hospital so often."

Berry and his colleagues discussed their findings in the Dec. 24 online issue of the journal Archives of Pediatrics & Adolescent Medicine.

To assess trends in admissions at children's hospitals, Berry's team studied data for more than 1.5 million pediatric patients hospitalized at least once at one of 28 urban pediatric hospitals between 2004 and 2009.

All the hospitals provide patient information to the Pediatric Health Information System, which represents about half of the nation's freestanding children's hospitals. Patients of all ages were included, given that many kids over age 18 continue receiving care at children's hospitals as they age.

Although there was a significant increase in pediatric hospitalizations during the study time frame, hospitals saw a bigger rise in the admissions of chronically sick children (up by more than 19 percent) compared with those who did not have a chronic condition (up by less than 14 percent).

The biggest increase (nearly 33 percent) was seen among children diagnosed with a severe chronic illness that affected at least two body systems. The most common combination of conditions was cerebral palsy and asthma. By 2009 this group of children constituted more than 19 percent of all the hospitalized patients, and contributed to more than 50 percent ($9.2 billion) of hospital charges, the study found.

Based on the findings, Berry suggested that children's hospitals need to proactively prepare financially and organizationally for the long-term likelihood that their patient pool will become increasingly sicker as a whole, and thereby more difficult and costly to treat.

In an accompanying editorial, Dr. Steven Altschuler, chief executive officer of the Children's Hospital of Philadelphia, said that although many factors contribute to the overall trend, the bottom-line conclusion is not surprising.

"Most pediatric programs in smaller community hospitals do not have the resources or expertise to care for these chronically ill children with multiple problems," he said. The large pediatric hospitals are able to integrate care involving multiple physicians across different specialties, "so these findings are not unexpected."

More information

For more on pediatric chronic illness, visit KidsHealth.org.

Copyright © 2012 HealthDay. All rights reserved.

  • Local NewsLocal NewsMore>>

  • Wedding reception at country club ends with brawl

    Wedding reception at country club ends with brawl

    Tuesday, September 16 2014 8:37 AM EDT2014-09-16 12:37:23 GMT
    New York State NewsNew York State News
    Police say they're investigating a large brawl that broke out at the end of a wedding reception held over the weekend at a suburban Buffalo country club. Officials tell local media that seven different police agencies were called in late Saturday to break up the fight at the Orchard Park Country Club. Officers say dozens of the approximately 200 guests were involved in the melee, which broke out after a member of the wedding party was tossed off the premises for inappropriate behavior.
    Police say they're investigating a large brawl that broke out at the end of a wedding reception held over the weekend at a suburban Buffalo country club. Officials tell local media that seven different police agencies were called in late Saturday to break up the fight at the Orchard Park Country Club. Officers say dozens of the approximately 200 guests were involved in the melee, which broke out after a member of the wedding party was tossed off the premises for inappropriate behavior.
  • Trump Plaza closes; mogul Donald Trump may step in

    Trump Plaza closes; mogul Donald Trump may step in

    Tuesday, September 16 2014 8:23 AM EDT2014-09-16 12:23:53 GMT
    A fourth Atlantic City casino has gone out of business.  Trump Plaza shut its doors at 6 a.m. Tuesday.  The casino at the center of the Boardwalk and the end of the Atlantic City Expressway has been declining for years, performing worse than any of the city's other casinos.
    A fourth Atlantic City casino has gone out of business.  Trump Plaza shut its doors at 6 a.m. Tuesday.  The casino at the center of the Boardwalk and the end of the Atlantic City Expressway has been declining for years, performing worse than any of the city's other casinos. Real estate mogul Donald Trump took to Twitter on Tuesday to say he left Atlantic City years ago but may return.
  • Street gangs tone down use of colors, tattoos

    Street gangs tone down use of colors, tattoos

    Tuesday, September 16 2014 8:19 AM EDT2014-09-16 12:19:09 GMT
    Law enforcement officials from coast to coast say street gangs are shying away from wearing their colors and are covering up or even altering their tattoos to avoid detection by police.  Hartford, Connecticut, Police Sgt. Johnmichael O'Hare says gone are the days when the Bloods wore red from head to toe. All you'll see now, he says, is maybe a red handkerchief sticking out of a back pocket.


    Law enforcement officials from coast to coast say street gangs are shying away from wearing their colors and are covering up or even altering their tattoos to avoid detection by police.  Hartford, Connecticut, Police Sgt. Johnmichael O'Hare says gone are the days when the Bloods wore red from head to toe. All you'll see now, he says, is maybe a red handkerchief sticking out of a back pocket.


Powered by WorldNow
Didn't find what you were looking for?
All content © Copyright 2000 - 2014 Fox Television Stations, Inc. and Worldnow. All Rights Reserved.
Privacy Policy | New Terms of Service What's new | Ad Choices