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儿科阿片类药物相关就诊对美国急诊科的影响。

The Impact of Pediatric Opioid-Related Visits on U.S. Emergency Departments.

作者信息

Champagne-Langabeer Tiffany, Cardenas-Turanzas Marylou, Ugalde Irma T, Bakos-Block Christine, Stotts Angela L, Cleveland Lisa, Shoptaw Steven, Langabeer James R

机构信息

Center for Health Systems Analytics, School of Biomedical Informatics, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX 77030, USA.

Department of Emergency Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX 77030, USA.

出版信息

Children (Basel). 2022 Apr 7;9(4):524. doi: 10.3390/children9040524.

Abstract

BACKGROUND

While there is significant research exploring adults' use of opioids, there has been minimal focus on the opioid impact within emergency departments for the pediatric population.

METHODS

We examined data from the Agency for Healthcare Research, the National Emergency Department Sample (NEDS), and death data from the Centers for Disease Control and Prevention. Sociodemographic and financial variables were analyzed for encounters during 2014-2017 for patients under age 18, matching diagnoses codes for opioid-related overdose or opioid use disorder.

RESULTS

During this period, 59,658 children presented to an ED for any diagnoses involving opioids. The majority (68.5%) of visits were related to overdoses (poisoning), with a mean age of 11.3 years and a majority female (53%). There was a curvilinear relationship between age and encounters, with teens representing the majority of visits, followed by infants. The highest volume was seen in the Southern U.S., with over 58% more opioid visits than the next highest region (Midwest). Charges exceeded USD 157 million, representing 2% of total ED costs, with Medicaid responsible for 54% of the total.

CONCLUSIONS

With increases in substance use among children, there is a growing need for pediatric emergency physicians to recognize, refer, and initiate treatments.

摘要

背景

虽然有大量研究探讨成年人使用阿片类药物的情况,但对于儿科人群在急诊科受到的阿片类药物影响关注极少。

方法

我们研究了医疗保健研究机构、国家急诊科样本(NEDS)的数据,以及疾病控制与预防中心的死亡数据。对2014 - 2017年期间18岁以下患者就诊时的社会人口统计学和财务变量进行了分析,匹配阿片类药物相关过量用药或阿片类药物使用障碍的诊断代码。

结果

在此期间,59,658名儿童因任何涉及阿片类药物的诊断到急诊科就诊。大多数就诊(68.5%)与过量用药(中毒)有关,平均年龄为11.3岁,大多数为女性(53%)。年龄与就诊次数之间存在曲线关系,青少年就诊次数最多,其次是婴儿。美国南部的就诊量最高,阿片类药物相关就诊次数比第二高的地区(中西部)多58%以上。费用超过1.57亿美元,占急诊科总费用的2%,其中医疗补助计划承担了总费用的54%。

结论

随着儿童物质使用情况的增加,儿科急诊医生识别、转诊和启动治疗的需求日益增长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cebf/9030094/4a37c0b44b51/children-09-00524-g001.jpg

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