Healthcare resources attributable to child tobacco smoke exposure.
Healthcare resources attributable to child tobacco smoke exposure.
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DOI：
10.1371/journal.pone.0247179
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Mahabee-Gittens EM
中科院分区：
文献类型：
--
作者：
Merianos AL;Jandarov RA;Gordon JS;Lyons MS;Mahabee-Gittens EM
烟草烟雾暴露（TSE）对美国医疗保健系统造成了经济损失。关于儿童急诊科（艾德）和紧急护理相关的医疗保健费用和烟草烟雾暴露患者的利用率的文献中存在空白。目的是纵向评估烟草烟雾暴露儿童（TSE组）与未暴露儿童（非TSE组）的儿科艾德就诊、紧急护理就诊和住院以及基线就诊费用。我们使用TSE组中380名0 - 17岁儿童的电子病历进行了一项回顾性研究，与非TSE组中1，140名儿童进行了比较，通过最近邻搜索按儿童年龄，性别，种族和种族进行了倾向评分匹配。使用线性和泊松回归模型。总体而言，儿童在基线访视后30天内平均有0.19（SE = 0.01）次重复访视，在12个月内平均有0.69（SE = 0.04）次儿科艾德访视和0.87（SE = 0.03）次紧急护理访视。TSE组（52.4%）中接受≥ 1次紧急护理访视的儿童百分比高于非TSE组（45.1%，p = 0.01）。TSE组儿童（M = 1，136.97美元，SE = 76.44）的基线儿科艾德访视费用高于非TSE组（M = 1，018.96美元，SE = 125.51，p = 0.01）。总体而言，儿童在12个月内有0.08（SE = 0.01）例住院，TSE组（M = 0.12，SE = 0.02）的平均住院率高于非TSE组（M = 0.06，SE = 0.01，p = 0.02）。儿童TSE组的住院风险是非TSE组的1.85倍（95% CI = 1.23，2.79，p = 0.003）。烟草烟雾暴露的儿童在12个月内有较高的紧急护理利用率和住院率，基线时儿科艾德费用较高。儿科艾德访视、紧急护理访视和住院可能是启动烟草控制干预措施的适当时机，这可能导致可预防的紧急护理访视减少。
Tobacco smoke exposure (TSE) places an economic toll on the U.S. healthcare system. There is a gap in the literature on pediatric emergency department (ED) and urgent care related healthcare costs and utilization specific to tobacco smoke-exposed patients. The objectives were to assess pediatric ED visits, urgent care visits and hospital admissions longitudinally, and baseline visit costs among tobacco smoke-exposed children (TSE group) relative to unexposed children (non-TSE group). We conducted a retrospective study using electronic medical records of 380 children ages 0–17 years in the TSE group compared to 1,140 in the non-TSE group propensity score matched via nearest neighbor search by child age, sex, race, and ethnicity. Linear and Poisson regression models were used. Overall, children had a mean of 0.19 (SE = 0.01) repeat visits within 30-days, and 0.69 (SE = 0.04) pediatric ED visits and 0.87 (SE = 0.03) urgent care visits over 12-months following their baseline visit. The percent of children with ≥ 1 urgent care visit was higher among the TSE group (52.4%) than the non-TSE group (45.1%, p = 0.01). Children in the TSE group (M = $1,136.97, SE = 76.44) had higher baseline pediatric ED visit costs than the non-TSE group (M = $1,018.96, SE = 125.51, p = 0.01). Overall, children had 0.08 (SE = 0.01) hospital admissions over 12-months, and the TSE group (M = 0.12, SE = 0.02) had higher mean admissions than the non-TSE group (M = 0.06, SE = 0.01, p = 0.02). The child TSE group was at 1.85 times increased risk of having hospital admissions (95% CI = 1.23, 2.79, p = 0.003) than the non-TSE group. Tobacco smoke-exposed children had higher urgent care utilization and hospital admissions over 12-months, and higher pediatric ED costs at baseline. Pediatric ED visits, urgent care visits, and hospitalizations may be opportune times for initiating tobacco control interventions, which may result in reductions of preventable acute care visits.
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影响因子：
5.5
作者：
Lemhoefer C;Rabe GL;Wellmann J;Bernstein SL;Cheung KW;McCarthy WJ;Lauridsen SV;Spies C;Neuner B
通讯作者：
Neuner B
影响因子：
3.3
作者：
Mason, Jacquelyn;Wheeler, William;Brown, Mary Jean
通讯作者：
Brown, Mary Jean
影响因子：
4.5
作者：
Mahabee-Gittens, E. Melinda;Ammerman, Robert T.;Gordon, Judith S.
通讯作者：
Gordon, Judith S.
影响因子：
5.1
作者：
King, Brian A.;Patel, Roshni;Freeman, Alison
通讯作者：
Freeman, Alison
影响因子：
5.1
作者：
Merianos, Ashley L.;Jandarov, Roman A.;Mahabee-Gittens, E. Melinda
通讯作者：
Mahabee-Gittens, E. Melinda