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大小是否重要? 医院在儿童糖尿病护理中的数量和资源使用
Silvia A G de Vries1,2, Jessica C G Bak1,2, Dick Mul3
1Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Diabetic medicine : a journal of the British Diabetic Association
|November 29, 2023
概括
大型医院对儿科糖尿病护理的入院次数较少. 虽然各医院的技术使用情况相似,但中型中心的整体成本较高,尽管糖尿病护理费用无论医院的数量如何,都保持了可比性.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
背景情况:
- 儿童糖尿病护理日益专业化,需要多学科团队和先进的技术.
- 指导方针强调需要在治疗团队内拥有足够的经验,以获得最佳的患者结果.
- 医院的数量和资源分配是影响护理质量和支出的关键因素.
研究的目的:
- 评估荷兰糖尿病儿童医院患者数量与资源利用之间的关联.
- 分析医院规模如何影响儿童糖尿病管理的医院支出和护理费用.
- 根据医院规模和患者负担,确定医疗保健提供方面的潜在差异.
主要方法:
- 一项回顾性队列研究分析了来自荷兰44家医院的5082名儿童的医院索赔数据 (2019-2020).
- 医院被分为小型 (20-100名患者),中型 (100-200名患者) 和大型 (≥200名患者) 医院,以每年儿童糖尿病患者数量为基础.
- 住院,咨询,技术使用和支出数据根据患者人口统计和社会经济状况进行了调整.
主要成果:
- 与小型医院相比,大型医院的全因住院率明显较低 (OR 0.48).
- 虽然大型医院的中位数儿科医生访问量略高,但在多层次分析中,这种差异在统计学上并不显著.
- 糖尿病技术的使用,包括胰岛素和实时连续血糖监测,在医院体积类别之间没有显著差异. 中型医院的平均总支出最高 (每名患者6434欧元).
结论:
- 医院患者数量影响了儿童糖尿病管理中的护理提供模式.
- 较大的医院与住院率的降低有关,这表明潜在的效率提高.
- 尽管总体支出有所差异,但基于医院的数量,糖尿病特异性护理成本并没有显著差异,这表明不同规模的中心的糖尿病管理质量可比.
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