Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidites, and deaths
Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidites, and deaths
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DOI：
10.3171/ped/2008/1/2/131
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发表时间：
2008-02-01
影响因子：
1.9
通讯作者：
Kestle, John R. W.
中科院分区：
文献类型：
--
作者：
Simon, Tamara D.;Riva-Cambrin, Jay;Kestle, John R. W.
Object.本研究的目的是衡量美国小儿脑积水的住院医疗保健;描述小儿脑积水住院治疗的患者、医院和住院特征;并确定与死亡相关的特征。使用1997年、2000年和2003年医疗保健成本和利用项目儿童住院患者数据库（KID）进行了一项横断面研究，这些数据库是儿科患者出院的全国代表性加权数据集。脑积水相关住院被分类为脑脊液（CSF）分流相关（包括初始放置、感染、故障或其他）或非CSF分流相关。排除> 18岁的患者。KID提供了3年研究中665.7、659.7和673.2万次总排放量的加权估计值。每年有38，200 - 39，900例入院，391，000 - 433，000个住院日，儿科脑积水的总住院费用为14亿至20亿美元。2003年，脑积水占美国所有儿科住院病例的0.6%，但占儿科住院天数的1.8%，占所有儿科住院费用的3.1%。在研究期间，脑积水患儿年龄较大，合并症增加，并且更频繁地进入教学医院。与存活的儿童相比，存活的儿童更可能< 3个月，并且有与出生相关的入院，没有保险，有合并症，被转移，并且有非CSF分流相关的入院。在美国，患有脑积水的儿童患有慢性疾病，并且在住院天数和医疗保健费用中所占比例不成比例。自1997年以来，他们的年龄和合并症的数量都有所增加。要使发病率和死亡率发生重大变化，就必须进行重点研究并提供资金。
Object. The aims of this study were to measure inpatient health care for pediatric hydrocephalus in the US; describe patient, hospital, and hospitalization characteristics for pediatric hydrocephalus inpatient care; and determine characteristics associated with death.Methods. A cross-sectional study was performed using the 1997, 2000, and 2003 Healthcare Cost and Utilization Project Kids' Inpatient Databases (KID), nationally representative weighted data sets of hospital discharges for pediatric patients. A hydrocephalus-related hospitalization was classified as either cerebrospinal fluid (CSF) shunt-related (including initial placements, infections, malfunctions, or other) or non-CSF shunt-related. Patients > 18 years of age were excluded. The KID provided weighted estimates of 6.657, 6.597, and 6.732 million total discharges in the 3 study years.Results. Each year there were 38,200-39,900 admissions, 391,000-433,000 hospital days, and total hospital charges of $1.4-2.0 billion for pediatric hydrocephalus. Hydrocephalus accounted for 0.6% of all pediatric hospital admissions in the US in 2003, but for 1.8% of it] I pediatric hospital days and 3.1% of all pediatric hospital charges. Over the study years, children admitted with hydrocephalus were older, had an increase in comorbidities, and were admitted more frequently to teaching hospitals. Compared with children who survived, those who (lied were more likely to be < 3 months of age and have a birth-related admission, have no insurance, have comorbidities, be transferred, and have a non-CSF shunt-related admission.Conclusions. Children with hydrocephalus have a chronic illness and use a disproportionate share of hospital days and healthcare dollars in the US. Since 1997 they have increased in age and in number of comorbid conditions. For important changes in morbidity and mortality rates to be made, focused research efforts and funding are necessary.