Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
J Pediatr Adolesc Gynecol. 2020 Oct;33(5):484-488. doi: 10.1016/j.jpag.2020.03.001. Epub 2020 Mar 9.
To explore trends over time in the utilization of the Emergency Department (ED) for adolescents with abnormal uterine bleeding (AUB).
Retrospective cross-sectional study.
Nationwide Emergency Department Sample database (Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality, Rockville, MD).
Subset of adolescents aged 10-19 years from overall cohort of women aged 10-49 years.
All ED visits from 2010-2014 for which International Classification of Diseases, ninth revision codes for AUB were listed as the principal diagnosis were compared. Health insurance coverage, demographic factors, hospital characteristics, comorbid anemia, and comorbid bleeding disorders were explored.
Number of visits, ED disposition, blood transfusions, and billing for pelvic ultrasound.
There were an estimated 262,939 ED visits nationally for women aged 10-49 years for AUB in 2014. Of these, 12.7% (33,511/262,939) were from adolescents aged 10-19 years. The number of adolescent visits with an AUB diagnosis declined by 11% from 2010-2014 (37,642 vs 33,511; P = .026), while visits by patients aged 20-49 did not change significantly (215,309 vs 229,428; P = .19). The number of adolescent visits for which Medicaid was the primary payer increased slightly, from 17,283 to 18,785, from 2010 to 2014 (P = .152), while the number using self-pay decreased from 8769 (23.4%) in 2010 to 5146 (15.4%) in 2014 (P < .0001).
ED visits among adolescents with AUB decreased from 2010 to 2014. There was a sharp reduction in the number of visits funded by self-pay and a slight increase in visits funded by Medicaid.
探讨青少年异常子宫出血（AUB）患者在急诊科（ED）就诊利用趋势随时间的变化。
回顾性横断面研究。
全国急诊部抽样数据库（医疗保健成本和利用项目，医疗保健研究和质量局，罗克维尔，MD）。
整体队列中年龄为 10-49 岁的女性中年龄为 10-19 岁的青少年子集。
比较了 2010-2014 年列出国际疾病分类，第九版 AUB 作为主要诊断的所有 ED 就诊，探索了健康保险覆盖范围，人口统计学因素，医院特征，伴发贫血和伴发出血性疾病。
就诊次数，ED 处置，输血和盆腔超声计费。
2014 年，全国范围内有估计有 262939 名年龄在 10-49 岁的女性因 AUB 到 ED 就诊。其中，12.7%（33511/262939）为年龄在 10-19 岁的青少年。2010-2014 年 AUB 诊断青少年就诊人数减少了 11%（37642 比 33511；P=.026），而 20-49 岁患者就诊人数无明显变化（215309 比 229428；P=.19）。从 2010 年到 2014 年，以医疗补助为主要支付人的青少年就诊人数略有增加，从 17283 人增加到 18785 人，增加了 152%（P=.152），而自付人数从 8769 人（23.4%）减少到 5146 人（15.4%），减少了 154%（P<0.0001）。
2010 年至 2014 年，患有 AUB 的青少年在急诊科就诊的次数减少。自付人数减少，而医疗补助支付人数略有增加。
