Karolinska Institutet, Stockholm, Sweden.
Sachs' Children and Youth Hospital, South General Hospital, Stockholm, Sweden.
Acta Paediatr. 2018 Nov;107(11):2011-2018. doi: 10.1111/apa.14429. Epub 2018 Jun 27.
We investigated socio-economic and geographical determinants of hospital care for viral gastroenteritis in young children.
This is a register-based study in a national birth cohort of 752 078 children 0-5 years of age in Sweden during 2006-2012. Hazard ratios (HR) of time to first admission and first episode of outpatient emergency department (ED) care with a diagnosis of viral gastroenteritis were estimated with Cox regression.
The adjusted HRs for hospital admission with a diagnosis of viral gastroenteritis were increased when the mother was below 25 years at the birth of the child, 1.30 (95% CI: 1.24-1.35), had a short (<=9 years) education, 1.18 (95% CI: 1.12-1.23), a psychiatric disorder, 1.34 (95% CI: 1.30-1.39), and/or when parents were born outside Europe, 1.23 (95% CI: 1.18-1.29). In contrast, the disposable income of the family was only marginally associated with such hospital admissions. The pattern of HRs for outpatient ED hospital care was similar. Hospital care incidences for viral gastroenteritis differed considerably between Swedish counties.
Parental indicators associated with a lower level of health literacy increase the risk for hospital care due to gastroenteritis in young children. Information about oral rehydration should be provided in ways that are accessible to these parents.
我们研究了社会经济和地理因素对幼儿病毒性肠胃炎住院治疗的影响。
这是一项基于登记的研究，涉及瑞典 2006 年至 2012 年期间出生的一个全国性出生队列中的 752078 名 0-5 岁儿童。使用 Cox 回归估计了首次入院和首次因病毒性肠胃炎门诊急诊就诊的时间的风险比 (HR)。
当母亲在孩子出生时年龄低于 25 岁、教育程度较短（<=9 年）、患有精神障碍时，诊断为病毒性肠胃炎的住院 HR 增加，分别为 1.30（95%CI：1.24-1.35）、1.18（95%CI：1.12-1.23）、1.34（95%CI：1.30-1.39）和/或父母出生在欧洲以外地区时，1.23（95%CI：1.18-1.29）。相比之下，家庭可支配收入仅与这些住院治疗略有关联。门诊急诊就诊的 HR 模式相似。病毒性肠胃炎的住院治疗发生率在瑞典各郡之间存在显著差异。
与较低健康素养相关的父母指标会增加幼儿因肠胃炎住院治疗的风险。应通过父母能够理解的方式提供口服补液信息。
