Cincinnati Children's Hospital Medical Center, OH, United States of America; University of Cincinnati College of Nursing, OH, United States of America.
Cincinnati Children's Hospital Medical Center, OH, United States of America.
J Pediatr Nurs. 2021 Nov-Dec;61:96-101. doi: 10.1016/j.pedn.2021.03.028. Epub 2021 Apr 1.
To describe the proportion of children with an index hospitalization in 2014 who had established long-term invasive ventilator dependence (LTVD), and determine regional variation in hospital length of stay, charges, and readmissions.
Multicenter, longitudinal, retrospective cohort study using a recently established algorithm to identify children with LTVD from the Pediatric Health Information System database with an index hospitalization at least once during 2014, excluding normal newborn care or chemotherapy, and the subset with established LTVD. Hospitals were grouped by geographic regions. Analysis included descriptive statistics and multi-variable mixed modeling for length of stay, charges, and readmissions.
Of the 615,883 unique children discharged from 45 children's hospitals in 2014, 2235 (0.4%) had established LTVD. Of these, 342 (15%) were hospitalized in the Northeast, 677 (30%) Midwest, 733 (32%) South and 481 (22%) West. Most had at least two complex chronic conditions (97%) and used a medical device for at least two body systems (71%). No statistically significant regional variation was found for length of stay, charges, or readmissions after adjustment for child demographics, admission type, disposition, primary diagnosis, ICU stay, and number of chronic conditions.
This study characterized the population of children with LTVD hospitalized in 2014. No regional variation was found for length of stay, charges, or readmissions.
Children with established LTVD make up a small subset of all children admitted to children's hospitals however, they require substantial, costly, multifaceted care as most have additional complex chronic conditions and require multiple medical devices.
描述 2014 年索引住院的儿童中，建立长期有创通气依赖（LTVD）的比例，并确定住院时间、费用和再入院的区域差异。
采用多中心、纵向、回顾性队列研究，使用最近建立的算法，从儿科健康信息系统数据库中确定至少在 2014 年期间索引住院的儿童，排除正常新生儿护理或化疗，以及建立 LTVD 的亚组。根据地理位置将医院分组。分析包括描述性统计和多变量混合模型，用于住院时间、费用和再入院。
在 2014 年从 45 家儿童医院出院的 615883 名独特儿童中，有 2235 名（0.4%）建立了 LTVD。其中，342 名（15%）来自东北部，677 名（30%）来自中西部，733 名（32%）来自南部，481 名（22%）来自西部。大多数患儿至少有两种复杂的慢性疾病（97%），至少使用两种医疗器械治疗两种以上的身体系统（71%）。在调整儿童人口统计学、入院类型、处置、主要诊断、重症监护病房停留时间和慢性疾病数量后，住院时间、费用或再入院率在区域间没有发现统计学上的显著差异。
本研究描述了 2014 年住院的 LTVD 患儿的特征。在住院时间、费用或再入院率方面没有发现区域差异。
建立 LTVD 的儿童占所有入住儿童医院的儿童的一小部分，但由于大多数患儿还有其他复杂的慢性疾病，需要多种医疗器械，因此他们需要大量、昂贵、多方面的护理。
