Oliveira Patrícia V, Brocchi Beatriz S, Enes Carla C, Nucci Luciana B
School of Life Sciences, Postgraduate Program in Health Sciences, Pontifical Catholic University of Campinas, São Paulo, Brazil.
School of Life Sciences, Department of Speech, Language, and Hearing Sciences, Pontifical Catholic University of Campinas, São Paulo, Brazil.
Eur J Pediatr. 2023 Sep;182(9):4153-4161. doi: 10.1007/s00431-023-05071-4. Epub 2023 Jul 12.
Access to advanced and sophisticated health technologies made it possible to increase the survival of children with complex chronic conditions. Thus, the profile of pediatric patients admitted to hospitals has changed in recent decades. In Brazil, there are few epidemiological studies on this subject. This study aims to evaluate the main characteristics and temporal trend of hospital admissions of children and adolescents with complex chronic conditions in Brazil, 2009-2020. This is a cross-sectional study with data on hospitalizations of children and adolescents with complex chronic conditions, extracted from the Hospital Information System of the Unified Health System, 2009-2020, in the 26 Brazilian states and the Federal District. The analysis included descriptive statistics and a generalized linear model. From 2009 to 2020, there were 1,337,120 hospitalizations of children and adolescents with complex chronic conditions, and of these, 735,820 (55.0%) were male. The percentage of hospital deaths during the analyzed period was 4.0%. The most recurrent diagnostic category was malignancy (41.0%), with an annual incidence increase of 2.61 (95% CI: 1.16-4.05). Between 2009 and 2019, the increase in hospitalizations for complex chronic conditions was 27.4% for boys and 25.2% for girls, and the reductions in the number of hospitalizations for other causes were 15.4% and 11.9% for boys and girls, respectively. Conclusions: Hospitalizations for complex chronic conditions in pediatrics are increasing in Brazil. This increase is a new challenge for the Brazilian public health system. What is Known: • The profile of pediatric patients admitted to hospitals has changed in recent decades, with a reduction in the total number of hospitalizations, but with an increase in the complexity and costs of these hospitalizations. • The world's scientific production on CCC is concentrated in the United States health care system. Epidemiological studies on the topic in universal health care systems are scarce. What is New: • This is the first study that evaluated the temporal trend of hospitalizations of children and adolescents with CCC in Brazil. • Hospitalizations for CCC in pediatrics are increasing in Brazil, with emphasis on the condition of malignancy, higher incidence in males and in children under one year of age. Furthermore, our study found a decrease in hospitalizations for other pediatric causes.
获得先进和精密的医疗技术使得患有复杂慢性病的儿童存活率得以提高。因此，近几十年来，住院儿科患者的情况发生了变化。在巴西，关于这一主题的流行病学研究很少。本研究旨在评估2009 - 2020年巴西患有复杂慢性病的儿童和青少年住院的主要特征及时间趋势。这是一项横断面研究，数据来源于2009 - 2020年巴西26个州和联邦区统一卫生系统的医院信息系统中患有复杂慢性病的儿童和青少年的住院情况。分析包括描述性统计和广义线性模型。2009年至2020年，患有复杂慢性病的儿童和青少年住院1337120例，其中735820例（55.0%）为男性。分析期间的住院死亡率为4.0%。最常见的诊断类别是恶性肿瘤（41.0%），年发病率增长2.61（95%可信区间：1.16 - 4.05）。2009年至2019年，患有复杂慢性病的男孩住院率增长27.4%，女孩增长25.2%，男孩和女孩因其他原因住院人数分别减少15.4%和11.9%。结论：巴西儿科复杂慢性病住院人数在增加。这一增长对巴西公共卫生系统来说是一个新挑战。已知情况：•近几十年来，住院儿科患者情况发生了变化，住院总数减少，但这些住院的复杂性和成本增加。•世界上关于复杂慢性病的科研成果集中在美国医疗体系。普遍医疗体系中关于该主题的流行病学研究很少。新发现：•这是第一项评估巴西患有复杂慢性病的儿童和青少年住院时间趋势的研究。•巴西儿科复杂慢性病住院人数在增加，重点是恶性肿瘤情况，男性和1岁以下儿童发病率更高。此外，我们的研究发现其他儿科病因的住院人数减少。
