Hospital Utilization in Children With Medical Complexity in a Cross-Setting Complex Care Program.

INTRODUCTION: Children with medical complexity (CMC) account for disproportionate pediatric hospital utilization. Complex care programs (CCP) may reduce utilization but are often resource intensive. We evaluated whether enrollment in a cross-setting CCP was associated with reduced hospitalizations and inpatient days. METHODS: We conducted a retrospective cohort study of CMC enrolled in a children's hospital CCP from 2015 to 2024. The CCP supports cross-setting care through a small team (pediatric hospitalist, nurse practitioner, and community health worker) without dedicated clinic space. Outcomes were annualized hospitalization rates and inpatient days up to 2 years before and after enrollment. We used pre-post comparisons and multivariable negative binomial regression. RESULTS: Among 71 patients, median hospitalizations decreased from 3.5 to 2.0/year and inpatient days from 41.5 to 11.5/year (both p < .001). Adjusted analyses showed reductions of 32% in hospitalizations and 72% in inpatient days. CONCLUSIONS: CCP enrollment was associated with reduced hospital utilization among CMC.