Hospitalization Outcomes for Rural Children with Mental Health Conditions.
Hospitalization Outcomes for Rural Children with Mental Health Conditions.
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患有精神健康问题的农村儿童的住院结果。
DOI：
10.1016/j.jpeds.2020.09.067
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Gay JC
中科院分区：
文献类型：
--
作者：
Bettenhausen JL;Hall M;Doupnik SK;Markham JL;Feinstein JA;Berry JG;Gay JC
确定患有精神卫生疾病的农村儿童住院的地点，并确定基于住院地点的结果差异。使用2014年医疗保健研究和质量机构的全国再入院数据库，对2014年1月1日至2014年11月30日期间因精神健康住院的0-18岁美国农村儿童进行回顾性队列分析。农村儿童的住院治疗分为儿童医院、大城市非儿童医院或农村医院。医院位置和结果之间的关系用逻辑回归（再入院）和负二项回归（住院时间（LOS））模型进行了评估。分类和回归树（CART）描述了农村医院最常见住院的特征。在21 666名农村儿童的精神健康住院治疗中，20.6%在农村医院。调整临床和人口统计学特征后，大城市非儿童医院和儿童医院的LOS高于农村医院[LOS：调整率比（aRR）1.35（95%CI 1.29，1.41）和aRR 1.33（95%CI 1.25，1.41）;所有P <0.01]。30-与乡村医院相比，大城市非儿童医院和儿童医院的日间再入院率较低[调整后的比值比（aOR）0.73（95%CI 0.63，0.84）和aOR 0.59（95%CI 0.48，0.71）;所有p均<0.001]。生活贫困的青少年男性外化行为障碍在农村医院住院的比例最高（69.4%）。虽然儿童医院和大城市非儿童医院的住院时间较长，但患者的结局更有利。
To identify where rural children with mental health conditions are hospitalized and to determine differences in outcomes based upon location of hospitalization. Retrospective cohort analysis of US rural children aged 0-18 years with a mental health hospitalization between January 1, 2014, and November 30, 2014, using the 2014 Agency for Healthcare Research and Quality’s Nationwide Readmissions Database. Hospitalizations for rural children were categorized to children’s hospitals, metropolitan non-children’s hospitals, or rural hospitals. Associations between hospital location and outcomes were assessed with logistic (readmission) and negative binomial regression (length of stay (LOS)) models. Classification and regression trees (CART) describe characteristics of most common hospitalizations at a rural hospital. Of 21,666 mental health hospitalizations of rural children, 20.6% were at rural hospitals. After adjustment for clinical and demographic characteristics, LOS was higher at metropolitan non-children’s and children’s hospitals compared with rural hospitals [LOS: adjusted rate ratio (aRR) 1.35 (95% CI 1.29, 1.41) and aRR 1.33 (95% CI 1.25, 1.41); all P < .01]. 30-day readmission was lower at metropolitan non-children’s and children’s hospitals compared with rural hospitals [adjusted odds ratio (aOR) 0.73 (95% CI 0.63, 0.84) and aOR 0.59 (95% CI 0.48, 0.71); all p<0.001]. Adolescent males living in poverty with externalizing behavior disorder had the highest percentage (69.4%) of hospitalization at rural hospitals. Although hospitalizations at children’s and metropolitan non-children’s hospitals were longer, patient outcomes were more favorable.
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DOI：
10.1111/j.1469-7610.2012.02598.x
发表时间：
2012-11-01
影响因子：
7.6
作者：
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通讯作者：
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影响因子：
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作者：
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DOI：
10.1097/00004583-199305000-00006
发表时间：
1993-05-01
影响因子：
13.3
作者：
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通讯作者：
BAUGHER, M