Rodday Angie Mae, Graham Robert J, Weidner Ruth Ann, Terrin Norma, Leslie Laurel K, Parsons Susan K
J Pediatr Health Care. 2017 Nov-Dec;31(6):654-662. doi: 10.1016/j.pedhc.2017.04.021. Epub 2017 Jun 16.
Children with chronic respiratory insufficiency and mechanical ventilation often experience acute illnesses requiring unscheduled hospitalizations. Health-related quality of life (HRQL) may predict future health care utilization.
Participants were 30 days to 22 years old with chronic respiratory insufficiency (N = 120). Parent-proxies completed global HRQL and general health measures. Outcomes were total health care (emergency department, outpatient, inpatient) and inpatient days over 6 months. Adjusted negative binomial regression estimated the effects of global HRQL and general health on utilization.
Three quarters of children had any utilization; 32% had hospitalizations. Children with poor/fair global HRQL had 3.7 times more health care days than those with very good/excellent global HRQL. Children with poor/fair global HRQL had 6.3 times more inpatient days than those with very good/excellent global HRQL. Similar relationships existed between general health and utilization.
HRQL was associated with health care and inpatient days. Clinical teams can use HRQL as a marker for utilization risk, enabling potentially earlier intervention, better outcomes, and lower costs.
患有慢性呼吸功能不全且需要机械通气的儿童经常经历需要非计划住院治疗的急性疾病。健康相关生活质量（HRQL）可能预测未来的医疗保健利用情况。
参与者年龄在30天至22岁之间，患有慢性呼吸功能不全（N = 120）。家长代理完成全球HRQL和一般健康指标。结局指标为6个月内的总医疗保健（急诊科、门诊、住院）和住院天数。调整后的负二项回归估计全球HRQL和一般健康对医疗保健利用的影响。
四分之三的儿童有任何医疗保健利用情况；32%的儿童有住院治疗。全球HRQL为差/一般的儿童的医疗保健天数是全球HRQL为非常好/优秀的儿童的3.7倍。全球HRQL为差/一般的儿童的住院天数是全球HRQL为非常好/优秀的儿童的6.3倍。一般健康与医疗保健利用之间也存在类似关系。
HRQL与医疗保健和住院天数相关。临床团队可以将HRQL用作医疗保健利用风险的标志物，从而有可能进行更早的干预、取得更好的结局并降低成本。
