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February 2013

What Can Be Learned by Residents Caring for Children With Lifelong, Chronic, Complex Conditions?

Author Affiliations

Author Affiliation: Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.

JAMA Pediatr. 2013;167(2):192-193. doi:10.1001/2013.jamapediatrics.406

Anyone who has spent time caring for patients on the inpatient unit of a children's hospital during recent years will not be surprised by the findings of Berry and colleagues1 in this issue. Their cohort analysis, using the Pediatric Health Information System to assess data from 28 US freestanding urban pediatric hospitals, demonstrates that, while the number of pediatric patients hospitalized between 2004 and 2009 increased overall by 16.7%, hospitalizations for children with at least 1 chronic condition increased by 19.2%. There was an even greater increase (32.5%) among the subgroup of children with lifelong chronic conditions affecting 2 or more body systems and/or complex or progressive chronic conditions—a group they classified as study cohort 4. By 2009, children in this subgroup accounted for 19.2% of patients, 48.9% of hospital days, and 53.2% of hospital charges for these 28 children's hospitals.

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