Roussot M A, Lawrenson J B, Hewitson J, Smart R, De Decker H P
Division of Critical Care and Children's Heart Diseases, School of Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Rondebosch, Cape Town, South Africa.
S Afr Med J. 2006 Sep;96(9 Pt 2):924-30.
To compare children with Down syndrome and children without Down syndrome and investigate whether there is a significant difference in the burden that is placed on the health care system between these two groups only in respect of the repair of congenital heart disease at Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
This study is a retrospective case control review.
Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
The sample group of 50 Down syndrome children who had received cardiac surgery between January 1998 and June 2003 was compared with a control group of 50 nonsyndromic children who had received cardiac surgery during the same period.
Sex and diagnoses (cardiac and noncardiac), number of days spent in hospital and in ICU, complication rates, re-operation rates, early mortality rates, planned further cardiac surgery. Costs of these outcomes were not quantified in exact monetary terms.
There was no significant difference between the two groups in terms of the burden that was placed on the health care system. Similar complication rates, re-operation rates and early mortality rates were recorded for both groups. The Down syndrome group appeared to benefit more from cardiac surgery than the non-Down syndrome group.
Denying cardiac surgery to children with Down syndrome does not improve the efficiency of resource allocation. It is therefore not reasonable to suggest that the problem of scarce resources can be ameliorated by discriminating against children with Down syndrome.
比较患有唐氏综合征的儿童和未患唐氏综合征的儿童，仅就南非开普敦红十字会战争纪念儿童医院先天性心脏病修复方面，调查这两组儿童给医疗保健系统带来的负担是否存在显著差异。
本研究为回顾性病例对照研究。
南非开普敦红十字会战争纪念儿童医院。
将1998年1月至2003年6月期间接受心脏手术的50名唐氏综合征儿童样本组与同期接受心脏手术的50名非综合征儿童对照组进行比较。
性别及诊断结果（心脏和非心脏方面）、住院天数和重症监护病房天数、并发症发生率、再次手术率、早期死亡率、计划进行的进一步心脏手术。这些结果的费用未以确切货币形式量化。
两组在给医疗保健系统带来的负担方面无显著差异。两组的并发症发生率、再次手术率和早期死亡率相近。唐氏综合征组似乎比非唐氏综合征组从心脏手术中获益更多。
拒绝为唐氏综合征儿童进行心脏手术并不能提高资源分配效率。因此，认为通过歧视唐氏综合征儿童可缓解资源稀缺问题的观点是不合理的。
