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病院の利用率と,小児病院で再入院を繰り返している患者の特徴
Jay G Berry1, David E Hall, Dennis Z Kuo
1Division of General Pediatrics, Children's Hospital, Harvard Medical School, Boston, MA 02115, USA. jay.berry@childrens.harvard.edu
JAMA
|February 18, 2011
まとめ
繰り返し再入院する小児の小グループでは,医療費と入院費が大幅に増加しました. これらの患者はしばしば複雑な慢性疾患を患っており,同じ臓器システム内の問題のために再入院されました.
科学分野:
- 小児保健医療に関する研究
- 医療サービス 研究 医療サービス
- 医療における品質の向上
背景:
- 早期再入院は,医療の質の重要な指標である.
- 再入院パターンと慢性疾患の子どもへの影響に関するデータは限られている.
研究 の 目的:
- 定期的な再入院児の入院資源利用,臨床プロファイル,入院原因を特徴づける.
- 小児の集団における再発性入院のパターンと影響を理解する.
主な方法:
- 2003年から2008年の間に37の米国の小児病院に入院した30万人を超える患者の遡及的なコホート分析.
- 365日間の間隔で再入国パターンを追跡するために,2008年まで収集されたフォローアップデータ.
- 分析は,365日間の任意の期間に4回以上再入院した患者を特定することに焦点を当てました.
主要な成果:
- 患者の2.9%は365日間の間隔で4回以上再入院を経験し,入院の間の平均は37日でした.
- これらの頻繁な再入院は,全入院の18.8%と,全入院費用の23.2% (3.4億ドル) を占めた.
- 頻繁に再入院する患者は,複雑な慢性疾患 (89.0%),技術支援 (52.6%),公共保険 (56.3%),非ヒスパニック系黒人 (34.4%) を必要とする可能性が高くなりました.
結論:
- 小児患者のわずかな割合が,再発的な再入院による入院と費用の重要な部分を担っています.
- 再発性入院は,しばしば複雑な慢性疾患と,同じ臓器システム内の問題に関連しています.
- これらのパターンを理解することは,小児保健医療におけるケア品質と資源配置の改善に不可欠です.
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