Background: This study aimed to describe the clinical outcomes and medical costs of hospitalized children requiring daily medical care (CRDMC), a patient group for which government-led support has developed rapidly in Japan.

Methods: A retrospective longitudinal study was conducted using a nationwide administrative database. All hospitalizations of children aged under 18 years discharged from April 2014 to March 2021 were included. Clinical outcomes and medical costs were compared between CRDMC and non-CRDMC hospitalizations. The estimated increase in the proportion of CRDMC medical costs among all pediatric hospitalizations during the study period was also calculated.

Results: Among the 1,531,456 hospitalizations included, 91,413 were identified as CRDMC. CRDMC accounted for 3.7% of the annual unique inpatients. The 30-day readmission rate among CRDMC was 27.5%, and the rate among those receiving multiple types of medical care was higher at 33.7%. The inpatient medical cost of CRDMC accounted for 20.3% of pediatric inpatient medical costs, with an estimated rise of 1.2881 (95% confidence interval, 1.2110–1.3702) during the study period. In the breakdown of the medical costs, the proportion of injection drug fees increased most rapidly.

Conclusion: The high 30-day readmission rate in CRDMC was distinctive among the clinical outcomes. The proportion of medical costs for CRDMC in pediatric inpatients was high, although CRDMC accounted for only a small proportion of annual unique inpatients. Further support for CRDMC must be based on the unique characteristics of this population.

Background: Changes in nutritional status during the coronavirus disease 2019 (COVID-19) pandemic may be attributed to the obesity-causing environment that had existed before. This paper aimed to investigate trends in thinness, overweight, and obesity among Chinese children aged 2 to 18 years from 2010 to 2020 and assess the potential influence of pandemic.

Methods: The Chinese Family Panel Studies that were conducted every 2 years between 2010 and 2020 included 48,642 children between the ages of 2 and 18 years. Height and mass were reported, and the body mass index (BMI) was calculated. The prevalence of thinness, overweight, and obesity was estimated using sex- and age-specific BMI cut-offs adopted by the International Obesity Task Force and population-weighted procedures. Linear regressions were used to estimate trends.

Results: The prevalence of thinness decreased from 25.5% to 22.2% but increased among children aged 2 to 6 years. The prevalence of overweight and obesity decreased from 24.6% and 14.2% to 22.5% and 10.0%, respectively. However, these decreases in the prevalence of overweight and obesity were attributed mostly to children aged 2 to 6 years, and the prevalence increased slightly among children aged 13 to 18 years. The prevalence of obesity in 2020 among only boys aged 13 to 15 years was greater than the estimated projections using data from 2010 to 2018.

Conclusion: From 2010 to 2020, the prevalence of all forms of malnutrition among Chinese children decreased, with age disparities. During the pandemic, overweight became more common among pubertal boys. Future interventions as well as policies ought to give high-risk groups priority.