Recent trends in healthcare utilization among children and adolescents with hypertension in the United States.
Recent trends in healthcare utilization among children and adolescents with hypertension in the United States.
复制标题
美国有高血压的儿童和青少年医疗保健利用的最新趋势。
DOI：
10.1161/hypertensionaha.111.188813
复制
发表时间：
2012-08
期刊：
影响因子：
--
通讯作者：
Gipson DS
中科院分区：
文献类型：
--
作者：
Tran CL;Ehrmann BJ;Messer KL;Herreshoff E;Kroeker A;Wickman L;Song P;Kasper N;Gipson DS
摘要本研究旨在探讨住院高血压儿童之医疗服务利用情况。1997年、2000年、2003年和2006年的医疗保健成本和利用项目儿童住院患者数据库用于识别高血压住院。我们研究了患者和医院特征对高血压费用的影响。每个队列年的数据用于分析收费趋势。我们发现，从1997年到2006年，71282例儿童高血压住院治疗产生了31亿美元的总费用。约68%为10至18岁，55%为男孩，47%为白色。6%的高血压诊断代码的索赔也有终末期肾病或肾移植的诊断代码。随着时间的推移，高血压出院的频率增加（2-9岁和2-18岁年龄组P=0.02; 10-18岁年龄组P=0.03），高血压导致的住院费用比例也增加（P<0.0001）。住院时间和终末期肾病与住院相关费用的增加相关（分别为P<0.0001和P=0.03）。在10年的研究期间，所有年龄组的高血压相关住院率都在增加，与高血压相关的费用比例也在增加。终末期肾病的并存状况导致医疗费用显著增加。
The objective of this study was to evaluate the healthcare utilization of hospitalized children with hypertension. The Healthcare Cost and Utilization Project Kids' Inpatient Database, years 1997, 2000, 2003, and 2006, was used to identify hypertension hospitalizations. We examined the association of patient and hospital characteristics on hypertension charges. Data from each cohort year were used to analyze trends in charges. We found that 71282 pediatric hypertension hospitalizations generated $3.1 billion in total charges from 1997 to 2006. Approximately 68% were 10 to 18 years old, 55% were boys, and 47% were white. Six percent of claims with a diagnosis code for hypertension also had a diagnosis code for end-stage renal disease or renal transplant. The frequency of hypertension discharges increased over time (P=0.02 for each of age groups 2–9 years and 2–18 years; P=0.03 for age group 10–18 years), as well as the fraction of inpatient charges attributed to hypertension (P<0.0001). Length of stay and end-stage renal disease were associated with increases in hospitalization associated charges (P<0.0001 and P=0.03, respectively). During the 10-year study period, the frequency of hypertension-associated hospitalizations was increasing across all of the age groups, and the fraction of charges related to hypertension was also increasing. The coexisting condition of end-stage renal disease resulted in a significant increase in healthcare charges.