Regional variation of pediatric interhospital critical care transport in Japan
Regional variation of pediatric interhospital critical care transport in Japan
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DOI：
10.1111/ped.15492
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发表时间：
2023-01-01
影响因子：
1.4
通讯作者：
Yamaoka，Kazue
中科院分区：
文献类型：
--
作者：
Miura，Shinya;Miyata，Satoshi;Yamaoka，Kazue
背景：深入了解在医院之间运输的患病或受伤儿童的流行病学对于建立区域公共卫生医疗运输服务至关重要。虽然流行病学情况因国家和地区而异，但在日本尚未有很好的记录。在本报告中，我们描述了儿科医院间转运的数量，并检查了近十年来的区域变化和趋势。方法：我们使用日本消防和灾害管理机构的公共救护车国家数据库，对2010年、2013年和2016 - 2019年接受医院间转运的儿童（<15岁）进行了重复的横断面分析。我们根据患儿的疾病/损伤严重程度将病例分为重症监护转运（CCT）或非重症监护转运（NonCCT）。我们计算了全国人口调整后的有条件现金转移支付数量，并用分析思维描述了有条件现金转移支付数量的地区差异。结果有条件转移组23,506例，无条件转移组138,347例。经人口调整的国家平均CCT数量为255 / 100万人年。统计数据因县而异，从每100万人年25-536人不等。各县的年度趋势也各不相同，9个县增加，6个县减少，31个县保持不变。在分析区域差异时，潜在的影响因素包括可用的医院间运输服务和直接入院和转诊到三级保健医院的阈值，而区域差异与地理模式或人口规模没有很好的关联。结论日本公共救护车服务主要用于有条件现金援助和非有条件现金援助。未来制定儿科医院间交通政策时应考虑到地区差异。
BackgroundAn in‐depth understanding of the epidemiology of ill or injured children transported between hospitals is crucial in building regional medical transport services in public health. Although the epidemiological situation varies by nation and region, it has not been well documented in Japan. In this report we described the number of pediatric interhospital transportations and examined the regional variations and trends in the recent decade.MethodsWe performed repeated, cross‐sectional analyses of children (<15 years) undergoing interhospital transportation in 2010, 2013, and 2016–19, using the national database of public ambulances of the Fire and Disaster Management Agency in Japan. We stratified the cases into critical care transport (CCT) or non‐critical care transport (NonCCT) by the illness/injury severity of the transported children. We calculated the national population‐adjusted number of CCTs and described prefectural variations in CCT numbers with analytical thinking.ResultsThere were 23,506 CCTs and 138,347 NonCCTs. The national average of population‐adjusted CCT numbers was 255 per 1,000,000 person‐years. The statistics varied by prefectures, ranging from 25–536 per 1,000,000 person‐years. The annual trends were also diverse across prefectures, increasing in nine, decreasing in six, and static in 31 prefectures. In analytical thinking of regional variations, potential contributing factors included available interhospital transport services and the threshold of direct admission and referral to tertiary‐care hospitals, whereas regional variations were not well associated with geographical patterns or population size.ConclusionsPublic ambulance services were substantially used for CCTs and NonCCTs in Japan. Regional variations should be taken into account for the future policymaking on pediatric interhospital transportation.