Iftikhar Mustafa, Junaid Nadia, Lemus Marili, Mallick Zyannah N, Mina Syeda A, Hannan Urooba, Canner Joseph K, Latif Asad, Shah Syed Mahmood Ali
Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
Johns Hopkins Surgery Center for Outcomes Research (JSCOR), Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.
Am J Ophthalmol. 2018 Jan;185:101-109. doi: 10.1016/j.ajo.2017.10.014. Epub 2017 Oct 31.
To determine the national estimates, demographics, and costs of inpatient eye care in the United States (US).
Retrospective cross-sectional study.
National Inpatient Sample (NIS), a representative sample of all US community hospitals, was used to analyze inpatient admissions with a primary ophthalmic diagnosis from 2001 to 2014. National estimates of the most prevalent diagnoses were determined, and descriptive statistics were calculated for demographics and costs.
From 2001 to 2014, there were an estimated 671 324 inpatient admissions (male patients, 51.6%; mean [standard deviation] age, 44.5 [27.3] years) in the US owing to an ophthalmic disorder-an annual rate of 16 per 100 000 population. The Mid-Atlantic region had the highest rate. Most admissions were owing to nontraumatic disorders (75.3%), classified as emergencies (41.8%), and covered by public insurance (48.9%). The median length of stay was 2 days and mortality was 0.2%. The total inflation-adjusted cost over the 14-year period was $5.9 billion. The most prevalent diagnosis was orbital cellulitis (14.5%), followed by orbital floor fracture (9.6%) and eyelid abscess (6.0%). Most diagnoses were infectious (28.0%) and the majority were attributed to external disease (24.3%). A total of 31.1% of all patients had an ophthalmic procedure, pars plana vitrectomy (4.8%) being the most common one.
There were around 48 000 ophthalmic inpatient admissions in the US costing $421 million every year. Orbital pathology, namely infection and trauma, was the leading cause of admissions. Implementing interventions to decrease the incidence of these conditions may significantly reduce the burden of inpatient ophthalmic care.
确定美国住院眼科护理的全国估计数、人口统计学特征及费用。
回顾性横断面研究。
使用全国住院患者样本（NIS），这是美国所有社区医院的代表性样本，分析2001年至2014年主要眼科诊断的住院病例。确定最常见诊断的全国估计数，并计算人口统计学特征和费用的描述性统计数据。
2001年至2014年，美国因眼科疾病估计有671324例住院病例（男性患者占51.6%；平均[标准差]年龄为44.5[27.3]岁），年发病率为每10万人16例。大西洋中部地区发病率最高。大多数住院病例是由于非创伤性疾病（75.3%），归类为急诊（41.8%），并由公共保险支付（48.9%）。中位住院时间为2天，死亡率为0.2%。14年期间经通胀调整后的总费用为59亿美元。最常见的诊断是眼眶蜂窝织炎（14.5%），其次是眶底骨折（9.6%）和眼睑脓肿（6.0%）。大多数诊断为感染性疾病（28.0%），大多数病因是外部疾病（24.3%）。所有患者中共有31.1%接受了眼科手术，其中玻璃体切割术（4.8%）最为常见。
美国每年约有48000例眼科住院病例，费用为4.21亿美元。眼眶病变，即感染和创伤，是住院的主要原因。实施干预措施以降低这些疾病的发病率可能会显著减轻住院眼科护理的负担。
