Trends in US Pediatric Hospital Admissions in 2020 Compared With the Decade Before the COVID-19 Pandemic.
Trends in US Pediatric Hospital Admissions in 2020 Compared With the Decade Before the COVID-19 Pandemic.
复制标题
DOI：
10.1001/jamanetworkopen.2020.37227
复制
发表时间：
2021-02-01
影响因子：
13.8
通讯作者：
Horvat CM
中科院分区：
文献类型：
--
作者：
Pelletier JH;Rakkar J;Au AK;Fuhrman D;Clark RSB;Horvat CM
与前几年相比，2020年1月至6月儿科住院量有何变化？这项横断面研究是对儿科健康信息系统数据库中49家医院的5例 424 688住院患者进行的，使用集合预测模型来证明2020年儿科住院患者与前几年的差异。2020年，入院人数最多减少了45.4%，医院费用减少了27.7%，除出生外，所有检查的诊断都大幅减少。在这项研究中，在2019年冠状病毒病大流行期间，在一系列不同的诊断中，2020年的儿科住院患者减少了。2020年初，美国宣布进入公共卫生紧急状态，以应对冠状病毒病2019年(新冠肺炎)，并实施了各种社会疏远措施。新冠肺炎大流行与儿科入院人数之间的关联尚不清楚。确定2020年儿科住院模式与前十年相比的变化。这项横断面研究包括49家为儿科健康信息系统数据库做出贡献的美国医院。住院人数被转换为时间序列数据，并生成了集合预测模型，以分析与前几年相比，2020年一系列诊断的入院人数。当时的环境是住院治疗。纳入2010年1月1日至2020年6月30日期间因住院就诊而出院的所有患者。每次就诊时按初步诊断入院的人数。在49家医院的3名 372名 839名患者(年龄中位数5.1[四分位数]年龄，5.1[0.7-13.3]岁；2名 823名 748[52.1%]男孩；3名 171名 224[58.5%]白人)的5名 424 688住院患者中，213名 571(3.9%)发生在2020年1月1日至2020年6月30日之间。与2010年至2019年期间相比，从2020年3月开始录取的人数有所减少。在最低点，2020年4月的入学人数比前几年减少了45.4%(2020年4月为23 798，而2010年至2019年4月的中位数为43 550[42 110-43 946])。经通胀调整的医院收费在2020年第二季度较前几年下降27.7%(2020年为4 327 580 511美元，而2010-2019年的中位数为5 983 142 102[5 762 690 022-6 324 978 456])。2010年至2019年期间，各种常见儿科疾病的季节性模式明显，包括哮喘、房间隔缺损、毛细支气管炎、糖尿病酮症酸中毒、川崎综合征、精神健康住院和创伤。整体模型能够识别入院诊断的季节性模式，并准确预测2019年7月至2019年12月的入院率，但无法预测2020年1月至2020年6月的入院率。在2020年1月至2020年6月期间，除出生外的所有诊断都下降到95%以下。在这项横断面研究中，在一系列儿科疾病中，美国医院的儿科入院人数在2020年有所下降。尽管某些情况的发病率可能有所下降，但其他情况可能代表着新冠肺炎大流行期间儿科护理方面未得到满足的需求。这项横断面研究考察了2020年儿科住院模式与前十年相比的变化。
How have pediatric inpatient admission volumes changed in January to June 2020 compared with prior years? This cross-sectional study of 5 424 688 admissions at 49 hospitals in the Pediatric Health Information Systems database used ensemble forecasting models to demonstrate differences between inpatient pediatric admissions in 2020 compared with prior years. There was a maximum 45.4% reduction in admissions in 2020, associated with a 27.7% reduction in hospital charges, with significant reductions in all examined diagnoses except for birth. In this study, inpatient pediatric admissions in 2020 were reduced across a heterogeneous range of diagnoses during the coronavirus disease 2019 pandemic. In early 2020, the United States declared a public health emergency in response to coronavirus disease 2019 (COVID-19) and implemented a variety of social distancing measures. The association between the COVID-19 pandemic and the number of pediatric admissions is unclear. To determine the changes in patterns of pediatric admissions in 2020 compared with the prior decade. This cross-sectional study included 49 US hospitals contributing to the Pediatric Health Information Systems database. Inpatient admissions were transformed into time-series data, and ensemble forecasting models were generated to analyze admissions across a range of diagnoses in 2020 compared with previous years. The setting was inpatient admissions. All patients discharged between January 1, 2010, and June 30, 2020, from an inpatient hospital encounter were included. Number of hospital admissions by primary diagnosis for each encounter. Of 5 424 688 inpatient encounters among 3 372 839 patients (median [interquartile range] age, 5.1 [0.7-13.3] years; 2 823 748 [52.1%] boys; 3 171 224 [58.5%] White individuals) at 49 hospitals, 213 571 (3.9%) were between January 1, 2020, and June 30, 2020. There was a decrease in the number of admissions beginning in March 2020 compared with the period from 2010 to 2019. At the nadir, admissions in April 2020 were reduced 45.4% compared with prior years (23 798 in April 2020 compared with a median [interquartile range] of 43 550 [42 110-43 946] in April 2010-2019). Inflation-adjusted hospital charges decreased 27.7% in the second quarter of 2020 compared with prior years ($4 327 580 511 in 2020 compared with a median [interquartile range] of $5 983 142 102 [$5 762 690 022-$6 324 978 456] in 2010-2019). Seasonal patterns were evident between 2010 and 2019 for a variety of common pediatric conditions, including asthma, atrial septal defects, bronchiolitis, diabetic ketoacidosis, Kawasaki syndrome, mental health admissions, and trauma. Ensemble models were able to discern seasonal patterns in admission diagnoses and accurately predicted admission rates from July 2019 until December 2019 but not from January 2020 to June 2020. All diagnoses except for birth decreased below the model 95% CIs between January 2020 and June 2020. In this cross-sectional study, pediatric admissions to US hospitals decreased in 2020 across an array of pediatric conditions. Although some conditions may have decreased in incidence, others may represent unmet needs in pediatric care during the COVID-19 pandemic. This cross-sectional study examines the changes in patterns of pediatric admissions in 2020 compared with admissions in the prior decade.
登录
查看更多内容
影响因子：
2.4
作者：
Feudtner C;Feinstein JA;Zhong W;Hall M;Dai D
通讯作者：
Dai D
DOI：
10.1186/s12966-020-00987-8
发表时间：
2020-07-06
影响因子：
8.7
作者：
Moore, Sarah A.;Faulkner, Guy;Tremblay, Mark S.
通讯作者：
Tremblay, Mark S.
影响因子：
33.9
作者：
Moreland, Amanda;Herlihy, Christine;Baldwin, Grant
通讯作者：
Baldwin, Grant
影响因子：
16.2
作者：
Jackson, Crystal C.;Albanese-O'Neill, Anastasia;Siminerio, Linda M.
通讯作者：
Siminerio, Linda M.
影响因子：
11.8
作者：
Friedrich, Frederico;Ongaratto, Renata;Pinto, Leonardo Araujo
通讯作者：
Pinto, Leonardo Araujo