复杂的慢性疾病和限制生命状态对儿科住院治疗的影响:观察性研究
Idoya Serrano-Pejenaute1,2, Itziar Astigarraga3,4, Álvaro Sánchez Pérez5
1Department of Pediatrics, Hospital of Zumarraga, Barrio Argixao, S/N, 20700, Zumarraga, Spain. idoya.serranopejenaute@osakidetza.eus.
患有复杂慢性疾病 (C-CD) 和限制生命条件 (LLC) 的儿童显著增加住院和死亡率. 限制生命的条件对儿科患者的资源利用和死亡概率产生了更大的影响.
科学领域:
- 儿童医疗保健的使用率
- 公共卫生系统 公共卫生系统
- 复杂的慢性疾病复杂的慢性疾病.
背景情况:
- 患有医疗复杂性的儿童 (CMC) 使用了大量的医疗保健资源,并且在医院死亡率很高.
- 复杂慢性疾病 (C-CD) 和限制生命的疾病 (LLC) 都是CMC的类别.
- 在C-CD和LLC之间存在重叠,两组都显示出高资源使用和死亡率,特别是LLC.
研究的目的:
- 评估CMC和LLC对巴斯克公共卫生系统 (BPHS) 住院的影响.
- 为了比较患有C-CD和LLC的儿童之间的住院医疗利用情况.
- 描述这些儿科组之间的医疗保健资源消费和死亡率的差异.
主要方法:
- 从2018年到2020年,在BPHS的儿科住院 (0-18岁) 的回顾性观察研究.
- 使用儿科医学复杂性算法识别C-CD.
- 使用生命限制条件的海恩目录来识别LLC.
主要成果:
- C-CD和LLC分别占儿科住院总数的15.4%和14.4%.
- 与C-CD患者相比,LCL患者更有可能需要呼吸/血液动力学支持和装置安置.
- 患有C-CD和LLC的儿童的入院频率更高,住院时间更长 (一般和ICU),并增加了住院死亡率,特别是患有LLC的儿童.
结论:
- 儿童医院入院的很大一部分是由于C-CD和LLC.
- 这两种情况都导致了医院资源的大量利用和高的医院死亡率,而LLC更为明显.
- 建议对公共资助的卫生系统进行进一步的成本和支出研究.
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