Chen Pei-Chun, Chien Kuo-Liong, Chang Ching-Wen, Su Ta-Chen, Jeng Jiann-Shing, Lee Yuan-Teh, Sung Fung-Chang
Institution of Environmental Health, National Taiwan University Hospital, Taipei.
J Pediatr. 2008 Mar;152(3):388-93. doi: 10.1016/j.jpeds.2007.08.003. Epub 2007 Nov 5.
Rarely has childhood stroke been compared with adult stroke for incidence or cost. This population study compared the stroke incidence and the associated hospitalization care costs between children and adults in Taiwan.
We used reimbursement claims data from the National Health Insurance program to identify stroke diagnoses in 1997 to 2003. The inpatient costs of both the first admission and recurrent stroke from 1979 childhood cases and 365,169 adult cases were compared by age and stroke subtype, excluding those less than 1 month of age.
The mean inpatient costs were higher for patients <10 and 10 to 19 years of age ($3565 per case) compared with adult cases ($1933), including both first and recurrent hospitalizations, and they were higher for the recurrent cases. Patients <10 years old had the highest proportional incidence of hemorrhage events (71.4%), followed by patients in the 10- to 19-year-old group (61.4%), and the lowest for adults (21.3%). Hemorrhagic events incurred 2 to 12 times higher cost than other types of stroke.
The hospitalization care costs for stroke are higher for children than for adults because of a greater proportion of hemorrhagic cases among children.
儿童中风与成人中风在发病率或成本方面很少被比较。这项人群研究比较了台湾儿童和成人的中风发病率及相关住院护理成本。
我们使用了国民健康保险计划的报销数据来确定1997年至2003年的中风诊断。比较了1979例儿童病例和365169例成人病例首次入院和复发性中风的住院费用,按年龄和中风亚型进行比较,排除年龄小于1个月的病例。
10岁及10至19岁患者的平均住院费用(每例3565美元)高于成人病例(1933美元),包括首次和复发性住院,而复发性病例的费用更高。10岁以下患者出血事件的比例发病率最高(71.4%),其次是10至19岁组的患者(61.4%),成人最低(21.3%)。出血性事件的费用比其他类型的中风高出2至12倍。
由于儿童出血性病例的比例较高,儿童中风的住院护理成本高于成人。