唐氏综合症儿科诊所十年的影响

IF 2.5 4区 医学 Q2 HEALTH POLICY & SERVICES Journal of Policy and Practice in Intellectual Disabilities Pub Date : 2023-08-31 DOI:10.1111/jppi.12471
Francis Hickey, Kristine Wolter-Warmerdam, Patricia Winders, Samantha Holland, Karen Kelminson, Dee Daniels
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引用次数: 1

摘要

报告美国新闻与世界报道确定的美国十大儿科医院之一的新儿科唐氏综合征(DS)中心的10年经验,该中心为患有唐氏症的儿童和年轻人提供服务。这是一项回顾性队列研究设计,在一个单一的大型儿科转诊中心专门研究退行性椎体滑移。儿童从由诊所访问和摄入表格以及电子医疗记录组成的综合诊所数据库中确定。首次就诊时的平均年龄为5.50岁(SD±5.64)。大多数患者有胃肠道诊断(n = 1319, 72.8%)、眼科异常(n = 1286, 71.0%)、心脏缺陷(n = 1056, 58.3%)和阻塞性睡眠呼吸暂停(n = 975, 53.8%)。美国儿科学会DS指南依从性最常见的转诊是实验室(n = 1152)、听力学(n = 1145)、眼科(n = 966)和心脏病学(n = 491)。诊所外展以确保社区儿科医生遵守指南对听力学有统计学影响(2017-2020年= 59.8%;2011-2016年= 65.5%)和睡眠研究转介(2017-2020年= 17.2%;2011-2016年= 28.0%)。在过去的10年里,DS儿科诊所提供了超过9800个科室和5250个检查或手术转诊。体积最大的手术是耳、鼻、喉扁桃体切除术/腺样体切除术和压力平衡管。我们的数据支持儿科DS诊所模式可以对患者的整体健康指标产生积极影响,并通过转诊预约、测试和程序产生可观的收入。
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Ten-year impact of a Down syndrome pediatric clinic

To report the 10-year experience of a new pediatric Down syndrome (DS) center at one of the top 10 pediatric hospitals in the United States identified by U.S. News and World Report serving children and young adults with DS. This is a retrospective cohort study design of 1812 children with DS at a single, large, pediatric referral center specializing in DS. Children were identified from the comprehensive clinic database populated by the clinic's Visit and Intake Forms and electronic medical records. The average age at initial clinic visit was 5.50 years (SD ± 5.64). Most patients had a gastrointestinal diagnosis (n = 1319, 72.8%), ophthalmologic anomaly (n = 1286, 71.0%), cardiac defect (n = 1056, 58.3%), and obstructive sleep apnea (n = 975, 53.8%). The most common referrals made for American Academy of Pediatrics DS Guidelines compliance were for labs (n = 1152), audiology (n = 1145), ophthalmology (n = 966), and cardiology (n = 491). Clinic outreach to community pediatricians to ensure compliance with guidelines was statistically impactful with audiology (2017–2020 = 59.8%; 2011–2016 = 65.5%) and sleep study referrals (2017–2020 = 17.2%; 2011–2016 = 28.0%). Over its 10 years, the DS pediatric clinic produced over 9800 department and 5250 testing or procedure referrals. The highest volume procedures were in ear, nose, and throat with tonsillectomy/adenoidectomy and pressure equalizer tubes. Our data support that the pediatric DS clinic model can positively impact the overall health measures of patients and produce significant revenue generated by referral appointments, testing, and procedures.

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