Deciphering the Link Between Diagnosis-Related Group Weight and Nursing Care Complexity in Hospitalized Children: An Observational Study
Background/Objectives: The increasing medical and nursing care complexity in hospitalized children represents a significant challenge for healthcare systems. However, the link between these two dimensions remains partially explored. This study aims to decipher the relationship between Diagnosis-Rela...
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2025-01-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/12/1/103 |
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| author | Manuele Cesare Fabio D’Agostino Emanuele Sebastiani Nursing and Public Health Group Gianfranco Damiani Antonello Cocchieri |
| author_facet | Manuele Cesare Fabio D’Agostino Emanuele Sebastiani Nursing and Public Health Group Gianfranco Damiani Antonello Cocchieri |
| author_sort | Manuele Cesare |
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| description | Background/Objectives: The increasing medical and nursing care complexity in hospitalized children represents a significant challenge for healthcare systems. However, the link between these two dimensions remains partially explored. This study aims to decipher the relationship between Diagnosis-Related Group (DRG) weight and nursing care complexity in hospitalized children and to identify the determinants of medical complexity. Methods: This retrospective study, conducted in an Italian university hospital, included children aged 2 to 11 years admitted to the hospital in 2022 with a minimum hospital stay of 2 days. Data were gathered from the Neonatal Pediatric Professional Assessment Instrument and the Hospital Discharge Register. DRG weight was used as an indicator of medical complexity, while the number of nursing diagnoses (NDs) documented in the first 24 h from hospital admission and the nursing actions (NAs) recorded during the patient’s hospital stay were used to measure nursing care complexity. Correlation analyses were conducted to explore the associations between DRG weight, NDs, and NAs. Stepwise regression was run to identify the key determinants of medical complexity across sociodemographic, clinical, organizational, and nursing variables. Results: Among 914 patients (mean age of 6.11 ± 2.90 years), the median DRG weight was 0.6982 (IQR: 0.5522). Patients had an average of 3.89 ± 2.83 NDs and a median of 17 NAs (IQR: 8). Significant correlations were found between NDs and NAs (r<sub>s</sub> = 0.507; <i>p</i> < 0.001), as well as between DRG weight and the frequency of NDs (r<sub>s</sub> = 0.232; <i>p</i> < 0.001) and NAs (r<sub>s</sub> = 0.184; <i>p</i> < 0.001). Stepwise regression indicated that the number of NAs, surgical DRG, scheduled admissions, and ND frequency were significant determinants of DRG weight (R<sup>2</sup> = 0.311; adjusted R<sup>2</sup> = 0.308; <i>p</i> < 0.001). Conclusions: In children, DRG weight is also influenced by nursing care complexity, alongside clinical and organizational factors. An integrated approach is essential to enhance pediatric care and patient outcomes. |
| format | Article |
| id | doaj-art-a085810332034a5698eb664db553a72f |
| institution | Kabale University |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Children |
| spelling | doaj-art-a085810332034a5698eb664db553a72f2025-01-24T13:27:19ZengMDPI AGChildren2227-90672025-01-0112110310.3390/children12010103Deciphering the Link Between Diagnosis-Related Group Weight and Nursing Care Complexity in Hospitalized Children: An Observational StudyManuele Cesare0Fabio D’Agostino1Emanuele Sebastiani2Nursing and Public Health Group3Gianfranco Damiani4Antonello Cocchieri5Gemelli IRCCS University Hospital Foundation, 00168 Rome, ItalyDepartment of Medicine, Saint Camillus International University of Health Sciences, 00131 Rome, ItalyDepartment of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, ItalyCatholic University of the Sacred Heart, 00168 Rome, ItalySection of Hygiene, Woman and Child Health and Public Health, Gemelli IRCCS University Hospital Foundation, Catholic University of the Sacred Heart, 00168 Rome, ItalySection of Hygiene, Woman and Child Health and Public Health, Gemelli IRCCS University Hospital Foundation, Catholic University of the Sacred Heart, 00168 Rome, ItalyBackground/Objectives: The increasing medical and nursing care complexity in hospitalized children represents a significant challenge for healthcare systems. However, the link between these two dimensions remains partially explored. This study aims to decipher the relationship between Diagnosis-Related Group (DRG) weight and nursing care complexity in hospitalized children and to identify the determinants of medical complexity. Methods: This retrospective study, conducted in an Italian university hospital, included children aged 2 to 11 years admitted to the hospital in 2022 with a minimum hospital stay of 2 days. Data were gathered from the Neonatal Pediatric Professional Assessment Instrument and the Hospital Discharge Register. DRG weight was used as an indicator of medical complexity, while the number of nursing diagnoses (NDs) documented in the first 24 h from hospital admission and the nursing actions (NAs) recorded during the patient’s hospital stay were used to measure nursing care complexity. Correlation analyses were conducted to explore the associations between DRG weight, NDs, and NAs. Stepwise regression was run to identify the key determinants of medical complexity across sociodemographic, clinical, organizational, and nursing variables. Results: Among 914 patients (mean age of 6.11 ± 2.90 years), the median DRG weight was 0.6982 (IQR: 0.5522). Patients had an average of 3.89 ± 2.83 NDs and a median of 17 NAs (IQR: 8). Significant correlations were found between NDs and NAs (r<sub>s</sub> = 0.507; <i>p</i> < 0.001), as well as between DRG weight and the frequency of NDs (r<sub>s</sub> = 0.232; <i>p</i> < 0.001) and NAs (r<sub>s</sub> = 0.184; <i>p</i> < 0.001). Stepwise regression indicated that the number of NAs, surgical DRG, scheduled admissions, and ND frequency were significant determinants of DRG weight (R<sup>2</sup> = 0.311; adjusted R<sup>2</sup> = 0.308; <i>p</i> < 0.001). Conclusions: In children, DRG weight is also influenced by nursing care complexity, alongside clinical and organizational factors. An integrated approach is essential to enhance pediatric care and patient outcomes.https://www.mdpi.com/2227-9067/12/1/103standardized nursing terminologiesnursing complexity of caremedical complexitydiagnosis-related groupchildren |
| spellingShingle | Manuele Cesare Fabio D’Agostino Emanuele Sebastiani Nursing and Public Health Group Gianfranco Damiani Antonello Cocchieri Deciphering the Link Between Diagnosis-Related Group Weight and Nursing Care Complexity in Hospitalized Children: An Observational Study Children standardized nursing terminologies nursing complexity of care medical complexity diagnosis-related group children |
| title | Deciphering the Link Between Diagnosis-Related Group Weight and Nursing Care Complexity in Hospitalized Children: An Observational Study |
| title_full | Deciphering the Link Between Diagnosis-Related Group Weight and Nursing Care Complexity in Hospitalized Children: An Observational Study |
| title_fullStr | Deciphering the Link Between Diagnosis-Related Group Weight and Nursing Care Complexity in Hospitalized Children: An Observational Study |
| title_full_unstemmed | Deciphering the Link Between Diagnosis-Related Group Weight and Nursing Care Complexity in Hospitalized Children: An Observational Study |
| title_short | Deciphering the Link Between Diagnosis-Related Group Weight and Nursing Care Complexity in Hospitalized Children: An Observational Study |
| title_sort | deciphering the link between diagnosis related group weight and nursing care complexity in hospitalized children an observational study |
| topic | standardized nursing terminologies nursing complexity of care medical complexity diagnosis-related group children |
| url | https://www.mdpi.com/2227-9067/12/1/103 |
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