Characterisation of medical conditions of children with sickle cell disease in the USA: findings from the 2007-2018 National Health Interview Survey (NHIS).
Characterisation of medical conditions of children with sickle cell disease in the USA: findings from the 2007-2018 National Health Interview Survey (NHIS).
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DOI：
10.1136/bmjopen-2022-069075
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发表时间：
2023-02-28
期刊：
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
--
作者：
我们使用国家健康访谈调查(NHIS)数据集来检查并存疾病的患病率；探索获得医疗保健和特殊教育服务的障碍；并评估镰状细胞病(SCD)状况与人口统计学/社会经济状况(SES)以及健康的社会决定因素(SDoH)与美国儿童共病的关系。横截面。NHIS样本儿童核心问卷2007-2018年数据集。133 481名儿童；SCD的存在由儿童的成年人或监护人的肯定反应确定。在P<；0.05中，采用多变量Logistic回归来比较SCD状态、SES和SDoH与不同种族和黑人儿童不同健康状况之间的关系。133481名儿童(平均年龄8.5岁，SD：0.02)，215名SCD儿童，约82%的SCD儿童(加权)是黑人。患有SCD的儿童更有可能患有共病，即贫血(调整后的OR：27.1p<；0.001)。此外，与没有SCD的儿童相比，患有SCD的儿童至少去过两次或更多的急诊室(P<；0.001)，并且每年更有可能去看医生1-15次(P<；0.05)。SCD儿童的家庭收入(P<；0.001)和母亲受教育程度低于非SCD儿童(52.4%比63.5%(P<；0.05))。母亲具有高中学历的SCD儿童不太可能没有急诊室就诊或4-5次急诊室就诊，而更有可能在12个月内就诊2-3次急诊室。患有SCD的儿童经历了严重的共病情况，并有很高的医疗保健使用率，其中黑人儿童受到的影响不成比例。此外，母亲的教育状况和贫困水平说明了社会经济地位对SCD人群的医疗保健寻求行为的影响程度。SDoH对临床环境下的儿童SCD患者的治疗有重要意义。
We used the National Health Interview Survey (NHIS) data set to examine the prevalence of comorbid medical conditions; explore barriers to accessing healthcare and special educational services; and assess the associations between sickle cell disease (SCD) status and demographics/socioeconomic status (SES), and social determinants of health (SDoH) on comorbidities among children in the USA. Cross-sectional. NHIS Sample Child Core questionnaire 2007–2018 data set. 133 481 children; presence of SCD was determined by an affirmative response from the adult or guardian of the child. Multivariate logistic regression was used to compare the associations between SCD status, SES and SDoH for various medical conditions for all races and separately for black children at p<0.05. 133 481 children (mean age 8.5 years, SD: 0.02), 215 had SCD and ~82% (weighted) of the children with SCD are black. Children with SCD were more likely to suffer from comorbid conditions, that is, anaemia (adjusted OR: 27.1, p<0.001). Furthermore, children with SCD had at least two or more emergency room (ER) visits (p<0.001) and were more likely to have seen a doctor 1–15 times per year (p<0.05) compared with children without SCD. Household income (p<0.001) and maternal education were lower for children with SCD compared with children without SCD (52.4% vs 63.5% (p<0.05)). SCD children with a maternal parent who has < / > High School degree were less likely to have no ER visits or 4–5 ER visits, and more likely to have 2–3 ER visits within 12 months. Children with SCD experienced significant comorbid conditions and have high healthcare usage, with black children being disproportionately affected. Moreover, maternal education status and poverty level illustrates how impactful SES can be on healthcare seeking behaviour for the SCD population. SDoH have significant implications for managing paediatric patients with SCD in clinical settings.
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DOI：
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发表时间：
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期刊：
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