脑瘫儿童住院的费用和并发症。

N A Murphy, C Hoff, T Jorgensen, C Norlin, P C Young
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引用次数: 57

摘要

背景:虽然许多脑瘫(CP)患儿会出现需要住院治疗的继发性疾病,但这一人群的住院治疗情况尚未明确。目的:利用一个大型的国家数据集来描述CP患儿的住院特征,并将其与非CP患儿的住院情况进行比较。方法:分析医疗保健利用项目儿童住院患者数据库,该数据库是1997年美国医院儿科出院的加权调查。结果:1997年,有37,000名患有CP的儿童住院,产生的费用接近6亿美元。患有CP的儿童住院时间更长(6.3天对4.1天,p < 0.001),总费用更高(16,024美元对9952美元,p < 0.001),每次就诊的诊断次数更多(5.6次对3.0次,p < 0.001),手术次数更多(1.7次对1.1次,p < 0.001)。5类主要诊断占有CP患儿出院诊断率的83.2%(无CP患儿为48.6%,p < 0.001)。患有CP的儿童在出院时更常被转移到其他机构(p < 0.001)或规定的家庭保健(p < 0.001)。结论:CP患儿住院是卫生保健系统的一项主要支出。改善与CP相关的疾病管理的研究可以为儿童和家庭带来更好的结果,并可能降低与住院相关的费用。
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Costs and complications of hospitalizations for children with cerebral palsy.

Background: Although many children with cerebral palsy (CP) develop secondary conditions requiring hospitalization, in-patient hospital utilization by this population has not been characterized.

Objective: To characterize hospitalizations in children with CP and to compare them with hospitalizations of those without CP using a large national data set.

Methods: Analysis of the Healthcare Utilization Project Kid Inpatient Database, a weighted survey of paediatric discharges from US hospitals in 1997.

Results: In 1997, 37,000 children with CP were hospitalized, generating charges approaching 600 million dollars. Children with CP demonstrated longer lengths of stay (6.3 vs 4.1 days, p < 0.001), higher total charges (16,024 vs 9952 dollars, p < 0.001), more diagnoses (5.6 vs 3.0, p < 0.001) and more procedures (1.7 vs 1.1, p < 0.001) per admission. Five major diagnostic categories accounted for 83.2% of the discharge diagnoses for children with CP (48.6% for those without CP, p < 0.001). Children with CP were more often transferred to other facilities (p < 0.001) or prescribed home health care (p < 0.001) upon discharge.

Conclusions: Hospitalization of children with CP represents a major expenditure for health care systems. Studies to improve the management of conditions associated with CP could result in better outcomes for children and families and potentially decrease costs associated with hospitalization.

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