在儿童多器官功能障碍住院后的医疗保健资源使用和成本
Folafoluwa O Odetola1,2,3, Paul Lin3, Wen Ye3,4
1Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor.
JAMA network open
|January 29, 2025
概括
儿童多器官功能障碍 (MOD) 的幸存者在住院后的五年内面临着相当大的持续医疗费用和资源使用. 这凸显了在他们的后续护理中需要考虑经济福祉的必要性.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 医疗服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 多器官功能障碍 (MOD) 是住院期间儿童死亡的主要原因.
- 长期的医疗保健资源利用和 MOD 幸存的儿童的相关成本没有得到充分的记录.
研究的目的:
- 评估MOD住院后婴儿和儿童的纵向医疗保健资源使用和成本.
主要方法:
- 一项回顾性队列研究利用了2004-2019年全国范围的保险索赔数据.
- 倾向性得分加权均衡的MOD和非MOD队列 (出生至18岁).
- 概括估计方程分析了再住院,急救诊所访问和住院后长达5年的费用差异.
主要成果:
- 与非MOD队列 (1,691,793名儿童) 相比,MOD队列 (9,671名儿童) 在长达5年的时间里,急诊室访问和再入院的次数显著增加.
- 患有MOD的婴儿在急救诊所的次数增加了1.76倍,在30天后再入院的次数增加了12.45倍,持续长期.
- 对于MOD队列来说,每年医疗保健费用要高得多,特别是在住院后的第一年.
结论:
- 在MOD中幸存下来的儿童承担着相当大的持续的医疗保健资源使用和成本.
- 对MOD幸存者的后续护理应将经济福祉评估与临床健康监测相结合.
- 这些发现强调了小儿MOD的幸存者在住院后的巨大负担.
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