Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East West Rd, Honolulu, HI 96821. Email:
JABSOM Biostatistics Core Facility, Department of Quantitative Health Sciences, University of Hawai'i, Honolulu, Hawai'i.
Prev Chronic Dis. 2020 Jul 23;17:E67. doi: 10.5888/pcd17.190448.
Chronic disease prevalence among young people is understudied generally and specifically for Native Hawaiian, Filipino, and Pacific Islander youth who are at high risk for these conditions. We determined the statewide prevalence of chronic diseases in acute care for those aged 5 to 29 years, including Native Hawaiians, Filipinos, and Pacific Islanders.
We used Hawai'i statewide inpatient and emergency department (ED) data across all payers from 2015-2016 to determine the presence of at least 1 of 5 chronic conditions (ie, asthma, hypertension, chronic kidney disease, diabetes, stroke) from 13,514 inpatient stays by 9,467 unique individuals and 228,548 ED visits by 127,854 individuals.
Twenty-eight percent of youth who were hospitalized and 12% with an ED visit had at least 1 chronic condition. Medicaid covered more than half of these visits. When comparing patients with and without a chronic condition, race/ethnicity, age group, and payer varied significantly in both inpatient and ED settings. Patients with a chronic condition were disproportionately Native Hawaiian, Filipino, and Pacific Islander; 32.3% of those with an inpatient chronic condition and 34.9% of those with an ED chronic condition were Native Hawaiian. Prevalence of chronic conditions among racial/ethnic groups varied significantly by age.
Chronic diseases, including those more often seen in adulthood, are prevalent in young people in acute care settings in Hawai'i, with notable disparities. These findings can help justify, guide, and support programs that are needed to address these changing epidemiological trends, which may be of particular interest for Medicaid.
年轻人中慢性病的患病率总体上和具体到有患这些疾病高风险的夏威夷原住民、菲律宾裔和太平洋岛民青年人群中都研究不足。我们确定了全州范围内 5 至 29 岁人群在急症护理中患慢性病的流行情况，包括夏威夷原住民、菲律宾裔和太平洋岛民。
我们使用夏威夷州 2015-2016 年所有支付方的全州住院和急诊部 (ED) 数据，从 13514 次住院治疗的 9467 名患者和 228548 次 ED 就诊的 127854 名患者中确定至少存在 1 种以下 5 种慢性疾病（即哮喘、高血压、慢性肾病、糖尿病、中风）之一。
28%的住院患者和 12%的 ED 就诊患者至少有一种慢性疾病。这些就诊中有一半以上由医疗补助支付。在比较有和没有慢性疾病的患者时，在住院和 ED 环境中，种族/族裔、年龄组和支付方均存在显著差异。患有慢性疾病的患者中，夏威夷原住民、菲律宾裔和太平洋岛民的比例不成比例；住院慢性疾病患者中 32.3%和 ED 慢性疾病患者中 34.9%是夏威夷原住民。各族裔群体的慢性疾病患病率随年龄差异显著。
慢性疾病，包括那些更常见于成年期的疾病，在夏威夷的急症护理环境中普遍存在于年轻人中，且存在显著差异。这些发现可以帮助证明、指导和支持需要解决这些不断变化的流行病学趋势的计划，这些计划可能对医疗补助计划特别感兴趣。
