比较儿童住院患者数据库和国家儿科研究住院患者样本
Sarah C McBride1, Matt Hall2, Madelyn G Hall2
1Division of General Pediatrics (SC McBride and JG Berry), Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
Academic pediatrics
|August 31, 2023
概括
儿科研究人员应该注意的是,儿童住院患者数据库 (KID) 和国家住院患者样本 (NIS) 在常见住院病例中显示出出院数量和住院时间 (LOS) 的小差异,但在罕见疾病中显示出更大的差异.
科学领域:
- 儿科卫生服务研究 儿童卫生服务研究
- 医疗信息学 医疗信息学
- 生物统计学 生物统计学
背景情况:
- 儿科研究人员利用医疗保健研究和质量局 (AHRQ) 儿童住院数据库 (KID) 和国家住院样本 (NIS) 来分析国家儿科住院资源使用和结果.
- 在KID和NIS的抽样设计中固有的差异可能导致不同的研究结果.
研究的目的:
- 为了比较KID和NIS之间常见和罕见的儿科住院原因的出院数量和停留时间 (LOS).
- 从这两个大型儿科住院患者数据库中得出的国家估计中识别潜在的差异.
主要方法:
- 对2019年从KID和NIS的0-20岁儿童的数据进行了回顾性分析.
- 对正常新生儿和331个其他入院原因进行了排放计数和几何平均LOS的比较,按All-Payer Refined Diagnosis Related Groups (APR-DRG) 和年度排放量分数分类.
- 根据AHRQ关于聚类,分层和权重的指导方针分析数据,以考虑KID和NIS的不同采样设计.
主要成果:
- 全国估计的年度出院总数差异很小:正常新生儿的0.5%,其他入院原因的3.7%.
- 由于吸收原因,排放计数的差异在两个最低的体积分数 (<520个排放) 中增加:在200-520个体积中为9.5% (SD 7.9%) 和在200个体积以下为41.1% (SD 64.2%).
- 这些最低体积分值的停留时间 (LOS) 差异分别为7.9% (SD 7.1%) 和26.0% (SD 29.3%).
结论:
- 虽然KID和NIS在大批量儿科住院治疗中产生了类似的结果,但在每年大约500人或更少的住院治疗中出现了显著的差异.
- 对于涉及少于500例出院的研究群体的分析,KID可能是首选的数据库,因为它每家医院的儿科出院的采样率更高.
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