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食管闭锁和气管食管瘘患儿的多学科护理协调

Multidisciplinary coordination of care for children with esophageal atresia and tracheoesophageal fistula.

作者信息

Platt Jody M, Nettel-Aguirre Alberto, Bjornson Candice L, Mitchell Ian, Davis Kathryn, Bailey Ja Michelle

机构信息

Department of Pediatrics, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada.

Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

出版信息

J Child Health Care. 2025 Mar;29(1):67-78. doi: 10.1177/13674935231174503. Epub 2023 May 24.

Abstract

Esophageal Atresia/Tracheoesophageal Atresia (EA/TEF) is a multisystem congenital anomaly. Historically, children with EA/TEF lack coordinated care. A multidisciplinary clinic was established in 2005 to provide coordinated care and improve access to outpatient care. This single-center retrospective cohort study was conducted to describe our cohort of patients with EA/TEF born between March 2005 and March 2011, assess coordination of care, and to compare outcomes of children in the multidisciplinary clinic to the previous cohort without a multi-disciplinary clinic. A chart review identified demographics, hospitalizations, emergency visits, clinic visits, and coordination of outpatient care. Twenty-seven patients were included; 75.9% had a C-type EA/TEF. Clinics provided multidisciplinary care and compliance with the visit schedule was high with a median of 100% (IQR 50). Compared to the earlier cohort, the new cohort ( = 27) had fewer hospital admissions and LOS was reduced significantly in the first 2 years of life. Multidisciplinary care clinics for medically complex children can improve coordination of visits with multiple health care providers and may contribute to reduced use of acute care services.

摘要

食管闭锁/气管食管瘘(EA/TEF)是一种多系统先天性异常。从历史上看,患有EA/TEF的儿童缺乏协调的护理。2005年设立了一个多学科诊所,以提供协调的护理并改善门诊护理的可及性。进行这项单中心回顾性队列研究,以描述我们在2005年3月至2011年3月期间出生的EA/TEF患者队列,评估护理的协调性,并将多学科诊所中儿童的结局与之前没有多学科诊所的队列进行比较。通过病历审查确定了人口统计学、住院情况、急诊就诊、门诊就诊以及门诊护理的协调性。纳入了27名患者;75.9%患有C型EA/TEF。诊所提供多学科护理,就诊时间表的依从性很高,中位数为100%(四分位间距50)。与早期队列相比,新队列(n = 27)的住院次数较少,并且在生命的头2年中住院时间显著缩短。针对病情复杂儿童的多学科护理诊所可以改善与多个医疗服务提供者的就诊协调性,并可能有助于减少急性护理服务的使用。

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