Abstract
Objectives
To investigate the prevalence and background of children with medical complexity (CMC)
and its secular trend in Japan.
Methods
CMC were defined as patients under the age of 20 years requiring medical care and
devices. The patients were enrolled using the national health insurance claims data
of three hospitals and two rehabilitation centers in Tottori Prefecture. The study
period was divided into three periods: Period 1, 2007–2010; Period 2, 2011–2014; and
Period 3, 2015–2018.
Results
A total of 378 CMC were enrolled. The prevalence of CMC was 1.88 per 1000 population
among subjects aged <20 years in 2018, and it increased by approximately 1.9 times
during the study period. The number of CMC who presented with severe motor and intellectual
disabilities did not change from Period 1 to Period 3. Meanwhile, the number of CMC
who had relatively preserved motor and intellectual abilities increased from 58 to
98. The proportion of CMC who required respiratory management and oxygen therapy increased
by 1.3 and 1.8 times, respectively. By contrast, the proportion of CMC who need tube
feeding decreased significantly between periods 1 and 3 (P < 0.05).
Conclusions
The prevalence of CMC increased almost twice during the 12-year study period; however,
the increase in the number of patients with relatively preserved motor and intellectual
abilities was pronounced. This study showed that the need for medical care and devices
differed based on the underlying disorders and severity of CMC; therefore, individualized
medical, welfare, and administrative services and education about the various types
of CMC must be provided.
Keywords
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Article Info
Publication History
Published online: July 01, 2020
Accepted:
June 16,
2020
Received in revised form:
June 15,
2020
Received:
February 21,
2020
Identification
Copyright
© 2020 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
