Korvenranta Emmi, Linna Miika, Häkkinen Unto, Peltola Mikko, Andersson Sture, Gissler Mika, Hallman Mikko, Korvenranta Heikki, Leipälä Jaana, Rautava Liisi, Tammela Outi, Lehtonen Liisa
Department of Pediatrics, Turku University Hospital, Turku, Finland.
Acta Paediatr. 2007 Oct;96(10):1416-20. doi: 10.1111/j.1651-2227.2007.00471.x. Epub 2007 Sep 10.
To investigate the effect of maternal, infant and birth hospital district related factors on the length of initial hospital stay in very preterm infants. In addition, rehospitalization rate within the first year from the initial discharge was studied.
A register study covering all very preterm infants (gestational age < 32 weeks or birthweight < 1501 g) born alive in Finland between years 2000 and 2003 (N = 2148). Factors affecting length of stay (LOS) were studied using generalized linear model (GLM).
The proportion of very preterm infants born in a level III unit varied in the hospital districts from 53% to 94%. Median LOS was 53 days (interquartile range: 38-76). There were large regional differences in the LOS, the difference being up to 10.5 days among the hospital districts (p < 0.0001). Rehospitalization rate was 47.2% within the first year from the initial discharge, and the absence of rehospitalization was associated with a 4.1 days shorter initial LOS (p < 0.0001).
Our study showed large regional variation in LOS of very preterm infants despite similar case mix. We speculate that the variation depends on differences in treatment practices and discharge criteria.
探讨母亲、婴儿及出生医院所在地区相关因素对极早产儿首次住院时间的影响。此外，还研究了首次出院后第一年内的再住院率。
一项登记研究涵盖了2000年至2003年在芬兰出生的所有存活极早产儿（胎龄<32周或出生体重<1501克）（N = 2148）。使用广义线性模型（GLM）研究影响住院时间（LOS）的因素。
在不同医院地区，出生于三级医疗单位的极早产儿比例从53%到94%不等。中位住院时间为53天（四分位间距：38 - 76天）。住院时间存在较大的地区差异，各医院地区之间的差异高达10.5天（p < 0.0001）。首次出院后第一年内的再住院率为47.2%，未再住院与首次住院时间缩短4.1天相关（p < 0.0001）。
我们的研究表明，尽管病例组合相似，但极早产儿的住院时间存在很大的地区差异。我们推测这种差异取决于治疗方法和出院标准的不同。
