Popejoy Emma, Marufu Takawira C, Thomas David A, Gregory Rachel, Frost Adele, McNarry Nicola, Hurley Matthew, Bean Dorothy, Manning Joseph C
Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Children and Young People Health Research, School of Health Sciences, University of Nottingham, Nottingham, UK.
Child Care Health Dev. 2021 Jan;47(1):70-76. doi: 10.1111/cch.12818. Epub 2020 Oct 26.
Globally, the number of children and young people (CYP) with long-term ventilation (LTV) needs is increasing, with high associated health care costs, due to frequent hospital admissions and contact with community health care services. However, demographic, health care utilization and outcome details of the CYP cared for locally is unknown. This study aimed to examine health care utilization and outcomes for this patient population.
Routinely collected data from 2014 to 2018 were extracted from local LTV team records and from hospital electronic patient records. Descriptive and inferential statistical analysis was performed using SPSS 17.
A total of 112 CYP aged 0-17 years old were included in the evaluation. Sixty per cent (n = 67) commenced ventilation in hospital, and 62% (n = 69) had at-least one hospitalization event whilst they were on LTV, with a median length of stay of 3 days. Most hospitalizations were unplanned and respiratory in nature. Ninety-five per cent (n = 106) of CYP accessed at least one clinic appointment whilst on LTV, with a median of 20 outpatient clinic appointments during the study period. The majority of CYP received time-intensive support from LTV nurses and physiotherapists during the period that they received LTV. Minimal seasonal variation existed in relation to hospital admissions. Year on year increasing trend of hospital admissions was noted. The observed mortality rate was 3.6% (n = 4), 72.3% (n = 81) remained active on LTV, 14% (n = 16) were liberated from their ventilation and 9% (n = 10) transitioned to adult care by the end of the study.
The study highlights the most common modes of health care utilization for CYP with LTV needs. To enable formalization of future resource planning and accurate assessment of health care utilization in evaluations, there is an urgent need to create a systematic approach for relevant LTV data collection.
在全球范围内，需要长期通气（LTV）的儿童和青少年（CYP）数量正在增加，由于频繁住院以及与社区医疗服务接触，相关医疗保健成本高昂。然而，当地接受护理的CYP的人口统计学、医疗保健利用情况和结局细节尚不清楚。本研究旨在调查该患者群体的医疗保健利用情况和结局。
从当地长期通气团队记录和医院电子病历中提取2014年至2018年常规收集的数据。使用SPSS 17进行描述性和推断性统计分析。
共有112名0至17岁的CYP纳入评估。60%（n = 67）在医院开始通气，62%（n = 69）在接受长期通气期间至少有一次住院事件，中位住院时间为3天。大多数住院是计划外的，且性质为呼吸道疾病。95%（n = 106）的CYP在接受长期通气期间至少进行了一次门诊预约，在研究期间门诊预约的中位数为20次。大多数CYP在接受长期通气期间得到了长期通气护士和物理治疗师的高强度支持。住院情况的季节性变化极小。注意到住院人数呈逐年上升趋势。观察到的死亡率为3.6%（n = 4），72.3%（n = 81）仍在接受长期通气，14%（n = 16）脱离了通气，9%（n = 10）在研究结束时转入成人护理。
该研究突出了有长期通气需求的CYP最常见的医疗保健利用模式。为了使未来的资源规划正式化并在评估中准确评估医疗保健利用情况，迫切需要创建一种系统的方法来收集相关的长期通气数据。
