Adults With Chronic Health Conditions Originating in Childhood: Inpatient Experience in Children's Hospitals
Adults With Chronic Health Conditions Originating in Childhood: Inpatient Experience in Children's Hospitals
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DOI：
10.1542/peds.2010-2037
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发表时间：
2011-07-01
期刊：
影响因子：
8
通讯作者：
Slonim, Anthony D.
中科院分区：
文献类型：
--
作者：
Goodman, Denise M.;Hall, Matthew;Slonim, Anthony D.
目的：描述随着时间的推移，在儿童医院寻求住院治疗的成人人数的增长率。 患者和方法：我们分析了 1999 年 1 月 1 日至 2008 年 12 月 31 日期间，来自 30 家学术儿童医院住院患者的数据，包括按年龄组（儿科：21 岁）和疾病分类的增长率。 结果：共有 3 343 名患者2 143 696 名患者中有 194 人出院。过渡期患者占 2.0%，成人占 0.8%，18 岁以上患者共计 59 974 名。在研究期间，所有年龄组的独特患者数量、入院人数、患者天数和费用均有所增加，并且预计将继续增加。老年人的资源使用率不成比例地较高。过渡期患者的增长超过其他患者，出院人数年均增长 6.9%，患者日数增长 7.6%，收费增长 15%。 87% 的成人患有慢性疾病，而儿童患者的这一比例为 48%。与儿童患者相比，患有囊性纤维化、恶性肿瘤、癫痫以及成人脑瘫患者的住院天数增加率显着增加。除囊性纤维化和镰状细胞病外，过渡期患者和成年患者的所有诊断费用的年增长率均有所增加。结论：在儿童医院住院的患有儿童期疾病的成年人人数正在增加，随着时间的推移，疾病特异性的变化也有所不同。我们的研究结果强调需要积极主动地确定护理儿科疾病成年幸存者的策略。儿科2011; 128：5-13
OBJECTIVE: To describe the rate of increase of the population of adults seeking care as inpatients in children's hospitals over time.PATIENTS AND METHODS: We analyzed data from January 1, 1999, to December 31, 2008, from patients hospitalized at 30 academic children's hospitals, including growth rates according to age group (pediatric: aged 21 years) and disease.RESULTS: There were 3 343 194 hospital discharges for 2 143 696 patients. Transitional patients represented 2.0%, and adults represented 0.8%, totaling 59 974 patients older than 18 years. The number of unique patients, admissions, patient-days, and charges increased in all age groups over the study period and are projected to continue to increase. Resource use was disproportionately higher in the older ages. The growth of transitional patients exceeded that of others, with 6.9% average annual increase in discharges, 7.6% in patient-days, and 15% in charges. Chronic conditions occurred in 87% of adults compared with 48% of pediatric patients. Compared with pediatric patients, the rates of increase of inpatient-days increased significantly for transitional age patients with cystic fibrosis, malignant neoplasms, and epilepsy, and for adults with cerebral palsy. Annual growth rates of charges increased for transitional and adult patients for all diagnoses except cystic fibrosis and sickle cell disease.CONCLUSIONS: The population of adults with diseases originating in childhood who are hospitalized at children's hospitals is increasing, with varying disease-specific changes over time. Our findings underscore the need for proactive identification of strategies to care for adult survivors of pediatric diseases. Pediatrics 2011; 128: 5-13