Hospital charges of potentially preventable pediatric hospitalizations.
Hospital charges of potentially preventable pediatric hospitalizations.
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DOI：
10.1016/j.acap.2012.06.006
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发表时间：
2012-09
影响因子：
3.1
通讯作者：
Kuo, Dennis Z.
中科院分区：
文献类型：
--
作者：
Lu, Sam;Kuo, Dennis Z.
关键词：
减少可预防的住院人数是节省医疗保健费用的一个可能来源。然而，目前的文献缺乏对潜在可预防的儿科住院程度的描述。研究目的是（1）确定与潜在可预防的儿科住院相关的费用和（2）人口统计学特征。2006年儿童住院患者数据库的次要分析（加权N= 7，558，812）。ICD-9-CM编码的16个先前验证的儿科门诊护理敏感（ACS）的条件确定了潜在的可预防的住院治疗; 7个额外的条件反映了更新的护理指南。结果变量包括入院次数、住院天数和住院费用。与ACS相关的人口统计学和诊断变量与使用适当的个人水平权重的回归分析进行比较。2006年，儿科ACS住院总费用为40.5亿美元，住院天数为1,087,570天。两种呼吸系统疾病-哮喘和细菌性肺炎-占ACS住院费用的48.4%和ACS住院天数的46.7%。在多变量分析中，与ACS状况相关的变量包括：男性（OR：1.10; 95% CI：1.07-1.13）;黑人人种/种族（OR：1.22; 95% CI：1.16-1.27）或西班牙裔（OR：1.12; 95% CI：1.06-1.18）;急诊科（艾德）为入院来源（OR：1.37; 95% CI：1.27-1.48）。呼吸系统疾病是潜在可预防的儿科住院的最大比例，住院费用总额高达19.6亿美元。因ACS住院的儿童往往是男性，非白人，并通过急诊室入院。未来的研究，以防止儿科住院应检查有针对性的干预措施，在初级保健环境中，特别是周围的呼吸系统疾病和少数民族人群。
Reducing the number of preventable hospitalizations represents a possible source of healthcare savings. However, the current literature lacks a description of the extent of potentially preventable pediatric hospitalizations. The study objectives are to (1) identify the charges and (2) demographic characteristics associated with potentially preventable pediatric hospitalizations. Secondary analysis of the 2006 Kids’ Inpatient Database (weighted N=7,558,812). ICD-9-CM codes for 16 previously validated pediatric ambulatory care-sensitive (ACS) conditions identified potentially preventable hospitalizations; seven additional conditions reflected updated care guidelines. Outcome variables included number of admissions, hospitalization days, and hospital charges. Demographic and diagnostic variables associated with an ACS condition were compared with regression analyses using appropriate person-level weights. Pediatric ACS hospitalizations totaled $4.05B in charges and 1,087,570 hospitalization days in 2006. Two respiratory conditions—asthma and bacterial pneumonia—comprised 48.4% of ACS hospital charges and 46.7% of ACS hospitalization days. In multivariate analysis, variables associated with an ACS condition included: male gender (OR: 1.10; 95% CI: 1.07–1.13); race/ethnicity of black (OR: 1.22; 95% CI: 1.16–1.27) or Hispanic (OR: 1.12; 95% CI: 1.06–1.18); and emergency department (ED) as admission source (OR: 1.37; 95% CI: 1.27–1.48). Respiratory conditions comprised the largest proportion of potentially preventable pediatric hospitalizations, totaling as much as $1.96B in hospital charges. Children hospitalized with an ACS condition tend to be male, non-white, and admitted through the ED. Future research to prevent pediatric hospitalizations should examine targeted interventions in the primary care setting, specifically around respiratory conditions and minority populations.
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