在儿童医院新发精神病住院的资源利用趋势
Ankita Gupta1,2, Matt Hall3, Benjamin Masserano1,2
1Department of Pediatrics, Division of Pediatric Hospital Medicine, University of Texas Southwestern, Dallas, Texas, USA.
Journal of hospital medicine
|February 2, 2025
概括
儿科新发性精神病住院病例保持稳定,但医疗评估在儿童医院之间有很大差异. 增加的资源使用凸显了基于证据的实践指南的需要.
科学领域:
- 儿科精神病学 儿科精神病学
- 医疗保健管理的管理
- 临床流行病学临床流行病学
背景情况:
- 患有新发精神病的儿童经常需要住院接受全面的医疗评估.
- 了解管理变异对于优化儿童精神病紧急情况的护理至关重要.
研究的目的:
- 评估儿科新发性精神病的医疗管理中的变化.
- 描述这些住院期间资源利用的趋势.
主要方法:
- 2011-2022年使用儿科健康信息系统 (PHIS) 数据库对7126例儿童 (7-18岁) 精神病住院指数进行分析.
- 排除患有复杂慢性疾病的儿童.
- 使用协差测试和通用估计方程进行统计分析,以评估资源利用 (药物,成像,实验室等) 的变化和趋势. ),对共变量进行调整.
主要成果:
- 在37家儿童医院 (p < .001) 观察到资源利用的显著差异.
- 抗精神病药物 (76%),血清化学 (77%) 和毒理实验室 (72%) 是最常见的;大脑MRI在22%使用.
- 使用的显著增加包括实验室测试,脑部成像,麻醉剂使用和静脉注射免疫球蛋白.
结论:
- 儿科新发性精神病的住院率稳定,但医疗评估存在显著的变化.
- 越来越多和多样化的资源利用强调了需要基于证据的实践指南和共识来管理这些案件的需要.
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