对患有复杂慢性疾病儿童的医院资源使用趋势
Nathaniel D Bayer1, Matthew Hall2, Maria Osipovich3
1Division of Pediatric Hospital Medicine, Department of Pediatrics, Golisano Children's Hospital, University of Rochester, Rochester, New York.
JAMA network open
|December 2, 2025
概括
患有复杂慢性疾病 (CCC) 的儿童从2000年到2022年大幅增加了医院资源的使用,主要是患有多种CCC的儿童. 卫生系统必须适应这些不断增长的住院护理需求.
科学领域:
- 儿童医疗保健的使用率
- 慢性疾病流行病学 慢性疾病流行病学
- 医疗服务研究 医疗服务研究
背景情况:
- 患有复杂慢性疾病 (CCC) 的儿童在住院治疗中代表了一个小但资源密集型的患者群体.
- 了解医疗保健利用趋势对于资源配置和医疗保健规划至关重要.
研究的目的:
- 分析2000年至2022年间美国有或没有CCC的儿童在医院出院,入床日和收费方面的国家趋势.
- 确定与CCC儿童资源利用增加相关的人口和临床因素.
主要方法:
- 一项回顾性,重复的横截面研究,利用儿童住院患者数据库 (KID) 从2000年到2022年.
- 分析包括0-18岁的儿童,根据复杂慢性疾病的数量 (CCC) 进行分类,使用ICD-9/10代码.
- 评估了出院率,入院日数和医院费用的趋势,以及社会人口统计和临床特征.
主要成果:
- 从2000年到2022年,患有一种或多种CCC的儿童的出院率增加了24.3%,而没有CCC的儿童的出院率却下降了.
- 患有多重CCC的儿童 (2个或更多) 的排放率显著增加 (60.9%至340.0%).
- 在研究期间,患有CCC的儿童占医院出院总数 (16.9%至21.9%),病床日数 (32.0%至44.1%) 和费用 (44.2%至59.5%) 的比例越来越高.
结论:
- 从2000年到2022年,CCC儿童的全国住院资源利用量大幅增加,主要是由多种疾病患者推动的.
- 这些发现强调了医疗保健系统急需加强资源,人员和支付模式,以可持续地管理对该人口的住院护理需求的不断升级.
- 越来越多的负担凸显了综合护理模式和预防策略对患有复杂慢性疾病的儿童的重要性.
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