医疗复杂性在与军方有联系的儿童中的发生率
JoAnna K Leyenaar1,2, Jackielyn Lanning3,4, Celeste J Romano3,4
1Dartmouth Health Children's, Lebanon, New Hampshire.
大约每9个美国军人儿童中就有1个在5岁时就会发展出复杂的疾病. 先天性异常,早产和低出生体重显著增加了这种风险,为这些儿童提供了照顾和资源分配的信息.
科学领域:
- 儿科健康 儿科健康
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 患有医疗复杂性 (CMC) 的儿童面临更高的不良健康结果和死亡风险.
- 支持CMC的专业需求需要了解其诊断发生率和风险因素.
- 这项研究侧重于美国军人家庭队列,以确定CMC患病率和相关的出生结果.
研究的目的:
- 估计美国军人家庭中活产婴儿60个月龄前CMC定义诊断的累计发病率.
- 检查特定出生结果与CMC定义诊断的发展之间的关联.
主要方法:
- 使用国防部医疗保健索赔数据 (2005-2020年) 的回顾性队列研究.
- 使用复杂慢性疾病分类系统和儿科医学复杂性算法从出生到60个月的CMC的识别.
- 用精细灰色回归模型计算出出生结果关联的调整危险比率 (aHR).
主要成果:
- 在60个月后,CMC定义诊断的累积发病率为12.0% (975,233例出生的108,133例).
- 三分之一的CMC诊断发生在新生儿中,近三分之二发生在婴儿期.
- 高风险的CMC与先天性异常 (aHR=25.2),非常早产 (aHR=17.6) 和非常低的出生体重 (aHR=13.7) 相关.
结论:
- 在美国军人家庭中,近九分之一的孩子在5岁时被诊断出患有复杂的医疗条件.
- 过早分娩,先天性异常和低出生体重与增加CMC风险密切相关.
- 研究结果支持对这一弱势儿科群体进行临床咨询和资源配置.
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