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Prevalence of medical technology assistance among children in Massachusetts in 1987 and 1990
J S Palfrey1, M Haynie, S Porter
1Children's Hospital, Boston, MA.
Insights
The number of children requiring medical technology remained stable from 1987-1990, with an estimated 2,200 children in Massachusetts dependent on these devices. Improved sampling revealed a shift in technology use and age distribution among pediatric patients.
Area of Science:
- Pediatric Health
- Medical Technology Use
- Public Health Surveillance
Background:
- Children dependent on medical technology represent a growing population requiring specialized care.
- Understanding the trends and patterns of medical technology use in children is crucial for effective healthcare planning.
- Previous estimates of this population may have been limited by data collection methods.
Purpose of the Study:
- To determine the size, distribution patterns, and trends of children using medical technology in Massachusetts.
- To estimate the unduplicated count of children aged 3 months to 18 years dependent on specific medical technologies.
- To analyze shifts in technology use and age demographics within this pediatric population.
Main Methods:
- Conducted surveys in Massachusetts in 1987 and 1990 to identify children using medical technology.
- Obtained unduplicated counts from medical and educational sources.
- Employed capture-recapture analysis to estimate the total population size and associated uncertainties.
Main Results:
- The estimated number of children dependent on medical technology was stable (2,147 in 1987, 2,237 in 1990).
- Identified increase in survey counts (1,085 to 1,540) likely due to improved sampling techniques.
- Observed shifts in technology use (increased oxygen/gastrostomy, decreased urostomy) and age distribution (younger children in 1990).
Conclusions:
- The population of children dependent on medical technology in Massachusetts was stable between 1987 and 1990.
- Prevalence estimates suggest approximately 101,800 children nationwide rely on medical technology.
- Findings support the need for continued policy analysis and program planning for medically complex children.
Abstract:
In 1987 and 1990 in Massachusetts, surveys were conducted to determine the size, pattern of distribution, and trends in the population of children assisted by medical technology. The authors obtained an unduplicated count of all Massachusetts children from 3 months to 18 years of age who used one or more of the following: tracheostomy, respirator, oxygen, suctioning, gastrostomy, jejunal or nasogastric feedings, ostomies, urethral catheterization, ureteral diversion, intravenous access, or dialysis. By comparing counts obtained from medical and educational sources, the authors were able to perform a capture-recapture analysis to estimate the overall number of children dependent upon these technologies. The number of children identified in our surveys increased from 1,085 in 1987 to 1,540 in 1990. However, the capture-recapture analysis yielded estimates of 2,147 plus or minus 230 for 1987 and 2,237 plus or minus 131 for 1990. This suggests that the population of children dependent upon medical technology was essentially stable during this period, and that the 42 percent increase in the number of children identified in our survey reflected improved sampling techniques. During the 3 years, shifts in the pattern of technology use were noted, however. Use of oxygen and gastrostomy increased, and urostomy use declined. A change in the age distribution of the children was also documented, with a shift in the preponderence of technology use from 12 to 24 months in 1987 to children in the first year of life in 1990. Using the 1990 estimate and the 1990 U.S. census figures, an overall prevalence estimate of 0.16 percent was calculated. Applying this to the U.S.child population yields an estimate of 101,800 children assisted by medical technology nationwide(assuming comparable technology use in other States). This information will facilitate policy analysis and program planning on regional and national levels for this medically complex group of children.