儿科麻醉症诊断和管理的发生率:来自索赔数据的证据
Si Hao Tang1, Jungwon Min2, Xuemei Zhang2
1Drexel University College of Medicine, Philadelphia, Pennsylvania.
概括
儿科麻醉症诊断很少见,但可能被低诊断,特别是在少数民族青年中. 许多儿童缺乏必要的诊断测试和专业护理,这表明在麻醉症诊断和治疗方面存在潜在的差异.
科学领域:
- 儿科睡眠医学 儿科睡眠医学
- 神经系统疾病的流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 麻醉症是一种慢性神经系统疾病,影响儿童和青少年.
- 准确的诊断和及时的管理对于改善结果至关重要.
- 关于儿科麻醉症发病率和护理模式的现有数据有限.
研究的目的:
- 为了确定麻醉症诊断在大量儿科人口中的发病率.
- 描述这些儿童随后得到的医疗护理.
- 调查诊断和护理方面的潜在社会人口差异.
主要方法:
- 使用了Merative MarketScan保险索赔数据库 (超过1200万年龄在6-17岁的年轻人).
- 使用ICD-10代码识别了新的麻醉症诊断.
- 在诊断后一年内评估诊断程序 (使用MSLT的多睡眠),药物治疗,临床检查和专科护理.
- 根据医疗补助保险的年轻人保险类型和种族/种族的差异.
主要成果:
- 麻醉症诊断的发病率为每10万名年轻人中有10人,主要是2型麻醉症.
- 青少年的诊断最常见,黑人与白人青年的比例更高,受医疗补助计划覆盖.
- 只有46.6%的被诊断的年轻人通过多重睡眠延迟测试 (MSLT) 进行了多睡眠监测.
- 专科护理 (肺部,神经病学) 和行为健康访问是不常见的.
- 与商业保险的同龄人相比,医疗补助保险的年轻人接受临床护理或接受MSLT的可能性要低得多.
结论:
- 儿科麻醉症的诊断很少发生,但可能被低诊断,特别是在少数群体中.
- 确诊的儿童中很大一部分没有接受推的诊断测试 (MSLT的多睡眠学).
- 对专业和行为健康服务的有限访问表明,护理和潜在差异存在重大差距.
- 调查结果强调需要提高诊断准确度和儿童麻醉症的公平管理策略.
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