Department of Pediatrics and Center for Outcomes Research, Children's Hospital of Philadelphia, 3535 Market St, Suite 1029, Philadelphia, PA 19104, USA.
Pediatrics. 2010 Dec;126(6):1182-90. doi: 10.1542/peds.2010-1119. Epub 2010 Nov 1.
Regionalization of health care is a method of providing high-quality, cost-efficient health care to the largest number of patients. Within pediatric medicine, regionalization has been undertaken in 2 areas: neonatal intensive care and pediatric trauma care. The supporting literature for the regionalization of these areas demonstrates the range of studies within this field: studies of neonatal intensive care primarily compare different levels of hospitals, whereas studies of pediatric trauma care primarily compare the impact of institutionalizing a trauma system in a single geographic region. However, neither specialty has been completely regionalized, possibly because of methodologic deficiencies in the evidence base. Research with improved study designs, controlling for differences in illness severity between different hospitals; a systems approach to regionalization studies; and measurement of parental preferences will improve the understanding of the advantages and disadvantages of regionalizing pediatric medicine and will ultimately optimize the outcomes of children.
医疗保健区域化是为大多数患者提供高质量、具有成本效益的医疗保健的一种方法。在儿科医学中，区域化已经在两个领域进行：新生儿重症监护和儿科创伤护理。区域化这些领域的支持文献展示了该领域内的一系列研究：新生儿重症监护的研究主要比较不同级别医院之间的差异，而儿科创伤护理的研究主要比较在单个地理区域建立创伤系统的影响。然而，这两个专业都没有完全区域化，可能是因为证据基础中的方法学缺陷。研究设计改进、控制不同医院之间疾病严重程度差异、区域化研究的系统方法以及测量父母偏好的研究将提高对儿科医学区域化的优缺点的理解，并最终优化儿童的结果。
