儿童炎症性肠病的卫生服务利用和专家护理:一个多省人口基的队列研究
M Ellen Kuenzig1,2, Alain Bitton3, Matthew W Carroll4
1SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada.
Inflammatory bowel diseases
|February 17, 2024
概括
10岁以下被诊断患有炎症性肠病 (IBD) 的儿童的急诊次数和克罗恩病相关手术次数较少. 儿科IBD患者的整体医疗服务利用率在各年龄组显示出类似的模式.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 儿科炎症性肠病 (IBD) 的发病率不断上升,需要了解医疗服务利用模式.
- 在被诊断患有IBD的年轻 (<10岁) 和年长 (10-<16岁) 儿童之间比较医疗服务利用率和手术需求至关重要.
研究的目的:
- 为了比较在不同年龄段被诊断患有IBD的儿童的医疗服务利用率和手术结果.
- 为了确定儿童IBD患者医疗保健需求的潜在年龄相关差异.
主要方法:
- 一项回顾性队列研究,使用来自加拿大五个省份的链接卫生行政数据.
- 使用负二项式回归比较门诊访问,急诊室访问和住院治疗.
- 通过考克斯的比例危险模型评估手术风险,调整人口因素,并通过元分析汇集各省的具体估计.
主要成果:
- 医院住院或门诊访问频率没有观察到显著的年龄差异.
- 年龄较小 (10岁以下) 的被诊断为儿童的急诊室访问次数较少 (RR,0.70;95% CI,0.50-0.97).
- 年龄较小的被诊断儿童不太可能需要与克罗恩病相关的手术 (HR,0.49;95% CI,0.26-0.92),而性结肠炎的结肠切除风险与结肠切除风险相似.
结论:
- 对于儿科炎性肠病的医疗服务利用模式在不同的早期诊断中基本上是相似的.
- 诊断为IBD的年轻儿童 (<10岁) 与老年儿童 (10-<16岁) 相比,可能有较低的紧急诊断和克罗恩氏相关手术风险.
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