Okumura Megumi J, Campbell Andrew D, Nasr Samya Z, Davis Matthew M
Division of General Internal Medicine, Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, MI, USA.
Arch Pediatr Adolesc Med. 2006 Oct;160(10):1054-60. doi: 10.1001/archpedi.160.10.1054.
To describe the inpatient length of stay and related charges for adults in the United States with childhood-onset chronic disease and to examine patterns with respect to different hospital settings.
We analyzed data from the 2002 Nationwide Inpatient Sample, a nationally representative data set of hospital discharges. We performed a case-mix-adjusted, sample-weighted regression analysis as well as descriptive statistics of hospital use among adults with childhood-onset chronic disease.
United States.
We identified hospitalizations for persons aged 18 years or older with a diagnosis of complex congenital heart disease, cystic fibrosis, sickle cell disease, or spina bifida. Main Exposure Childhood chronic illness.
Length of stay and total charges among pediatric, adult, and mixed hospitals.
In multivariate adjusted analyses, patients with complex congenital heart disease and cystic fibrosis had a significantly longer length of stay in pediatric hospitals than in adult or mixed hospitals (P<.001); no similar difference was found for sickle cell disease and spina bifida. For all of the 4 conditions, hospital charges were significantly greater in pediatric hospitals than in adult or mixed hospitals (P<.001 for cystic fibrosis, complex congenital heart disease, and sickle cell disease, and P<.01 for spina bifida).
The vast majority of persons who have survived to adulthood with complex congenital heart disease, cystic fibrosis, spina bifida, or sickle cell disease are hospitalized in hospitals that predominantly care for adults, where charges for care appear to be lower than in pediatric hospitals.
描述美国患有儿童期起病的慢性病的成年人的住院时间及相关费用，并研究不同医院环境下的模式。
我们分析了2002年全国住院患者样本的数据，这是一个具有全国代表性的医院出院数据集。我们进行了病例组合调整、样本加权回归分析以及对患有儿童期起病的慢性病的成年人的医院使用情况的描述性统计。
美国。
我们确定了年龄在18岁及以上、诊断为复杂先天性心脏病、囊性纤维化、镰状细胞病或脊柱裂的住院患者。主要暴露因素为儿童慢性病。
儿科医院、成人医院和综合医院的住院时间和总费用。
在多变量调整分析中，患有复杂先天性心脏病和囊性纤维化的患者在儿科医院的住院时间明显长于成人医院或综合医院（P<0.001）；镰状细胞病和脊柱裂未发现类似差异。对于所有这4种疾病，儿科医院的住院费用明显高于成人医院或综合医院（囊性纤维化、复杂先天性心脏病和镰状细胞病P<0.001，脊柱裂P<0.01）。
绝大多数患有复杂先天性心脏病、囊性纤维化、脊柱裂或镰状细胞病并存活至成年的患者在主要收治成人的医院住院，那里的护理费用似乎低于儿科医院。
