Williams Katie, Wargowski David, Eickhoff Jens, Wald Ellen
1 American Family Children's Hospital, Madison, WI, USA.
2 University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Clin Pediatr (Phila). 2017 Dec;56(14):1319-1327. doi: 10.1177/0009922816685817. Epub 2017 Jan 30.
Increasing evidence suggests children with Down syndrome do not receive recommended health care services. We retrospectively assessed adherence to the 2001 American Academy of Pediatrics health supervision guidelines for 124 children with Down syndrome. Cervical spine radiographs were completed for 94% of children, often preoperatively. Adherence to complete blood count recommendations was 55% (95% CI 44% to 66%); lower for males ( P = .01) and children with private medical insurance ( P = .04). Adherence to thyroid function recommendations was 61% (95% CI 54% to 67%); higher for children seen by a pediatrician ( P = .002) and with known thyroid disease ( P < .0001). Adherence to audiology and ophthalmology recommendations was 33% (95% CI 27% to 40%) and 43% (95% CI 37% to 50%), respectively. Adherence rates were higher for children referred to an otolaryngologist ( P = .0002) and with known eye disease ( P < .0001). Future efforts should identify barriers to care and improve adherence to recommended screening.
越来越多的证据表明，唐氏综合征患儿未接受推荐的医疗保健服务。我们回顾性评估了124名唐氏综合征患儿对2001年美国儿科学会健康监督指南的遵循情况。94%的患儿完成了颈椎X光检查，通常是在术前。对全血细胞计数建议的遵循率为55%（95%置信区间44%至66%）；男性患儿（P = 0.01）和有私人医疗保险的患儿（P = 0.04）的遵循率较低。对甲状腺功能建议的遵循率为61%（95%置信区间54%至67%）；由儿科医生诊治的患儿（P = 0.002）和已知患有甲状腺疾病的患儿（P < 0.0001）的遵循率较高。对听力和眼科建议的遵循率分别为33%（95%置信区间27%至40%）和43%（95%置信区间37%至50%）。转诊至耳鼻喉科医生的患儿（P = 0.0002）和已知患有眼部疾病的患儿（P < 0.0001）的遵循率较高。未来的工作应确定护理障碍，并提高对推荐筛查的遵循率。
