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Identifying multimorbidity patterns of non-communicable diseases in paediatric inpatients: a cross-sectional study in
Ning Chen1, Liang Zhou2, Jiaoling Huang2
1Tongji University School of Medicine, Shanghai, China.
Insights
Over 16% of pediatric inpatients in China have multiple non-communicable diseases (NCDs). Common NCD multimorbidity patterns were identified, highlighting the need for targeted prevention and resource allocation strategies.
Area of Science:
- Pediatric Health
- Chronic Disease Epidemiology
- Public Health Policy
Background:
- Non-communicable diseases (NCDs) pose a growing challenge in pediatric populations.
- Understanding multimorbidity (the co-occurrence of multiple NCDs) is crucial for effective healthcare management in children.
- Limited data exists on NCD multimorbidity patterns among pediatric inpatients in China.
Purpose of the Study:
- To investigate the prevalence and characteristics of NCD multimorbidity in pediatric inpatients in China.
- To identify common patterns of NCD multimorbidity among this population.
- To inform resource allocation and prevention strategies for pediatric NCDs.
Main Methods:
- A cross-sectional study was conducted using electronic health records from 17 hospitals in Shanghai, China (2011-2016).
- Data from 193,432 pediatric inpatients were analyzed, with a focus on 91,004 children diagnosed with NCDs.
- NCDs were classified using the International Classification of Diseases, 10th version (ICD-10) codes to identify multimorbidity.
Main Results:
- Approximately 47% of pediatric inpatients had at least one chronic disease, and 16.3% presented with multimorbidity.
- Congenital anomalies were a significant principal diagnosis (19.4%).
- Five distinct multimorbidity patterns were identified: neurological-respiratory, neurological-respiratory-ear, cardiovascular-circulatory, genitourinary (boys), and musculoskeletal-connective (adolescents).
Conclusions:
- Multimorbidity is prevalent among pediatric inpatients, necessitating careful consideration for resource allocation.
- Identified multimorbidity patterns underscore the need for further research into targeted prevention and innovative treatment strategies for children.
- These findings provide valuable insights for improving pediatric NCD care in China.
Objectives:
To enhance the understanding of non-communicable disease (NCD) multimorbidity in children who are inpatients by delineating the characteristics of and identifying patterns among paediatric inpatients with multimorbidity in China.
Design:
Cross-sectional study.
Setting:
Paediatric wards (n=17) in Pudong New Area, Shanghai, China.
Participants:
A total of 193 432 paediatric inpatients in the electronic health record systems of 17 hospitals from 2011 to 2016 participated in the study, and 91 004 children with NCDs were extracted and classified based on International Classification of Diseases, 10th version codes.
Main Outcome Measures:
Number of the NCDs and multimorbidity patterns of the paediatric inpatients.
Results:
In total, 47.05% (95% CI 46.83 to 47.27) of the paediatric inpatients had one or more chronic diseases, and 16.30% (95% CI 16.14 to 16.46) had multimorbidity. Congenital anomalies accounted for 19.43% (95% CI 19.25 to 19.61) of the principal diagnoses among the paediatric inpatients. Five common multimorbidity patterns were identified: a neurological-respiratory cluster, a neurological-respiratory-ear cluster, a cardiovascular-circulatory cluster, a genitourinary cluster (boy group) and a musculoskeletal-connective cluster (10-18 years age group).
Conclusions:
Multimorbidity in paediatric inpatients suggests that decisions about reasonable allocation of paediatric inpatient resources should be fully considered. Multimorbidity patterns in paediatric inpatients revealed that prevention, including innovative treatments targeting children, should be further studied.