Yamada, Hiroyuki Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University Researchers DB
Ohno, Koyo Department of Pediatrics, Tottori Prefectural Rehabilitation Center for Children with Disabilities
Shiota, Madoka Department of Pediatrics, Tottori Prefectural Rehabilitation Center for Children with Disabilities
Togawa, Masami Department of Pediatrics, Tottori Prefectural Central Hospital
Utsunomiya, Yasushi Department of Pediatrics, Tottori Prefectural Central Hospital
Akaboshi, Shinjiro Department of Pediatrics, Tottori Medical Center
Tsuchie, Hirokazu Department of Pediatrics, Tottori Prefectural Central Hospital / Department of Pediatrics, Tottori Prefectural Kousei Hospital
Okada, Takayoshi Department of Pediatrics, Tottori Prefectural Kousei Hospital
Oguri, Masayoshi Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University / Clinical Examination Department, Faculty of Health Sciences, Kagawa Prefectural University of Health Sciences Researchers DB
Higami, Shigeru Higami Ear-Nose-Throat, Snore and Sleep Clinic
Noma, Hisashi Department of Data Science, The Institute of Statistical Mathematics
ObjectivesTo investigate the prevalence and background of children with medical complexity (CMC) and its secular trend in Japan. MethodsCMC 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. ResultsA 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). ConclusionsThe 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.
Brain and Development
|Current Journal Title||
Brain and Development
(C) 2020 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
Yamada, Hiroyuki. Ohno, Koyo. Shiota, Madoka. et al. Prevalence and clinical characteristics of children with medical complexity in Tottori Prefecture, Japan: A population-based longitudinal study. Brain and Development. 42. 747-755. 2020-11-30.
Faculty of Medicine/Graduate School of Medical Sciences/University Hospital