Williams Sara E, Tran Susan T, Lynch-Jordan Anne, Goldschneider Kenneth R, Ting Tracy V, Kashikar-Zuck Susmita, Neilson Derek
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Am J Med Genet A. 2022 Apr;188(4):1109-1117. doi: 10.1002/ajmg.a.62625. Epub 2022 Jan 6.
Ehlers-Danlos syndrome (EDS) is a heterogeneous group of inherited disorders of connective tissue. EDS hypermobility type (EDS-HT), characterized by joint hypermobility, is most common and increasingly recognized in pediatrics. Treatment involves protecting joints, preventing injuries, and managing symptoms/comorbidities. Pediatric EDS-HT patients often see multiple medical providers; however, data on healthcare utilization (HCU) in this population are lacking. This retrospective, electronic chart review examines HCU data 1 year prior and subsequent to a new diagnosis of EDS-HT using Villefranche criteria. Demographics, diagnoses, and HCU (office visits, therapies, hospital encounters/procedures, and tests) were obtained for N = 102 youth attending a Connective Tissue Disorder Clinic over a 21-month timeframe. After EDS-HT diagnosis, HCU patterns shifted to reflect greater involvement of therapy (physical, psychological, and occupational) and symptom management. More genetics, rheumatology, and orthopedics visits occurred prediagnosis, and more physical therapy, pain management, cardiology, and neurology visits occurred postdiagnosis. Testing and hospital encounter/procedure frequencies did not change. Overall, the pattern of HCU changed from diagnostic to treatment, in accordance with evidence-based EDS-HT care. Understanding HCU patterns of pediatric patients with EDS-HT can elucidate patient interaction with the health care system, with the potential to inform and improve the standard of care.
埃勒斯-当洛综合征(EDS)是一组遗传性结缔组织疾病的统称。以关节活动过度为特征的EDS活动过度型(EDS-HT)最为常见,在儿科中越来越受到关注。治疗方法包括保护关节、预防损伤以及控制症状/合并症。患有EDS-HT的儿科患者通常会看多个医疗服务提供者;然而,这一人群的医疗服务利用(HCU)数据却很缺乏。这项回顾性电子病历审查使用维勒弗朗什标准,检查了EDS-HT新诊断前1年及诊断后的HCU数据。在21个月的时间里,从102名在结缔组织疾病诊所就诊的青少年中获取了人口统计学信息、诊断结果以及HCU数据(门诊就诊、治疗、住院诊疗/手术和检查)。在EDS-HT诊断后,HCU模式发生了变化,以反映出治疗(物理治疗、心理治疗和职业治疗)和症状管理的更多参与。诊断前更多的是遗传学、风湿病学和骨科就诊,诊断后更多的是物理治疗、疼痛管理、心脏病学和神经科就诊。检查和住院诊疗/手术频率没有变化。总体而言,HCU模式从诊断转向了治疗,这与基于证据的EDS-HT护理一致。了解患有EDS-HT的儿科患者的HCU模式可以阐明患者与医疗保健系统的互动情况,有可能为护理标准提供信息并加以改进。