@article{oai:tsukuba.repo.nii.ac.jp:00047899,
 author = {田宮, 菜奈子 and 宮園, 弥生 and Yamaoka, Yui and Tamiya, Nanako and Watanabe, Akimitsu and Miyazono, Yayoi and Tanaka, Ryuta and Matsuzawa, Akemi and Sumazaki, Ryo},
 issue = {7},
 journal = {Pediatrics international},
 month = {Apr},
 note = {Background
Few studies have investigated the hospital‐based care utilization of children with medical complexity (CMC) in Japan. This study examined the frequency and differences in hospital‐based care utilization for CMC according to the level of medical complexity (moderate and severe).
Methods
Medical records of three pediatric tertiary hospitals in one prefecture were examined in 2014. We examined the number of outpatient visits and of admissions to the hospital for CMC in the 5 years after the introduction of home medical care.
Results
Of 92 CMC, 55 had medical complexity that was moderate (CMC‐moderate) and 37 had medical complexity that was severe (CMC‐severe). The number of CMC who had medical care introduced at home had increased year by year, especially that of CMC <2 years old; the number of older CMC (i.e. 7–17 years old) had also increased in 2010–2014. The median total outpatient visits was 20 (IQR, 13–29 visits) for CMC‐moderate and 20 (IQR, 17–26 visits) for CMC‐severe in the first year. CMC‐severe had significantly longer length of admissions in the 5 years than CMC‐moderate. The number of total visits and admissions during the subsequent 4 years (from the second to the fifth year) was slightly decreased compared with the first year, but this was not significantly different.
Conclusions
CMC had high utilization of hospital‐based care, and consistently utilized hospital‐based care in the 5 years after the introduction of home medical care. Further study is needed to examine both hospital‐based and home/community‐based services use.},
 pages = {626--633},
 title = {Hospital-based care utilization of children with medical complexity in Japan},
 volume = {60},
 year = {2018}
}