The rising cost of hospital care for children with gastroparesis: 2004-2013
The rising cost of hospital care for children with gastroparesis: 2004-2013
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DOI：
10.1111/nmo.12869
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发表时间：
2016-11-01
影响因子：
3.5
通讯作者：
Mousa, H. M.
中科院分区：
文献类型：
--
作者：
Lu, P. L.;Moore-Clingenpeel, M.;Mousa, H. M.
背景：成人胃轻瘫（GP）的住院治疗费用正在增加。我们的目的是评估全科医生儿童的医院护理费用。方法利用儿童健康信息系统，选择2004 - 2013年诊断为GP （ICD-9 536.3）、消化不良及其他特定胃功能障碍（DYS, 536.8）和未明确胃功能障碍（UFD, 536.9）的住院患者。我们记录了住院日期、人口统计、费用和住院时间（LOS）。2004 - 2013年全科就诊4015例，其中女性54.2%，中位年龄8岁。全科医生的住院总费用增加了5.8倍，从6 185 390美元增加到35 654 075美元（p = 0.0001）。每次住院费用没有变化。0 ~ 5岁患者初次住院费用最高，16 ~ 21岁患者最低（p < 0.0001）。每年GP住院人数从252人增加到1310人（p < 0.0001），住院的特殊患者从174人增加到723人（p < 0.0001）。DYS/UFD的住院人数和独特患者人数也有所增加（p < 0.0001）。GP的LOS不随时间变化。女性和年轻的全科医生患者有更多的重复住院（p < 0.0001, p < 0.0001）。结论与推论2004年至2013年，由于住院人数和每年住院的特殊患者数量的增加，儿科全科医生住院的经济负担急剧增加。每次住院的费用和LOS保持稳定。与成人不同，DYS/UFD的住院率也有所增加，这表明全科医生住院率的增加并非继发于诊断方法的改变。
BackgroundThe cost of hospital care for adults with gastroparesis (GP) is increasing. Our objective was to evaluate the cost of hospital care for children with GP.MethodsUsing the Pediatric Health Information System, we selected hospitalizations with a diagnosis of GP (ICD-9 536.3), dyspepsia and other specified disorders of function of stomach (DYS, 536.8) and unspecified functional disorder of stomach (UFD, 536.9) from 2004 to 2013. We recorded dates of hospitalization, demographics, costs, and length of stay (LOS).Key ResultsFrom 2004 to 2013, 4015 patients were admitted for GP (54.2% female, median age 8 years). Total cost of hospitalization for GP increased 5.8 fold from $6 185 390 to $35 654 075 (p = 0.0001). Cost per hospitalization did not change. Cost of initial hospitalization was highest in patients 0-5 years and lowest in patients 16-21 years (p < 0.0001). Number of hospitalizations each year for GP increased from 252 to 1310 (p < 0.0001) and unique patients hospitalized increased from 174 to 723 (p < 0.0001). Number of hospitalizations and unique patients for DYS/UFD also increased (p < 0.0001). LOS for GP did not change with time. Females and younger GP patients had more repeat hospitalizations (p < 0.0001, p < 0.0001).Conclusions & InferencesThe financial burden of hospitalization for pediatric GP has increased dramatically from 2004 to 2013, driven by a rise in number of hospitalizations and unique patients hospitalized each year. Cost and LOS per hospitalization remain stable. Unlike in adults, hospitalizations for DYS/UFD have also increased, suggesting that the increase in hospitalizations for GP is not secondary to changing diagnostic practices.