Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Clin Pediatr (Phila). 2024 Feb;63(2):201-207. doi: 10.1177/00099228231200393. Epub 2023 Sep 13.
It is unclear if socioeconomic status (SES) factors influence severity of illness of patients hospitalized with bronchiolitis. This study was conducted to identify SES factors including the Center for Disease Control and Prevention's Social Vulnerability Composite Index (SVI), estimated income, proportion of minority, proportion of living below poverty, insurance status, and number of household members associated with length of stay (LOS) and intensive care unit admission. Infants hospitalized at a tertiary care urban center for bronchiolitis were identified using International Classification of Diseases codes. Federal information processing system codes were identified from home address and paired with SVI and 2018 census tract. Other measures of SES were obtained from the Federal Financial Institutions Examination Council. Number of household members, insurance, age, sex, and history of prematurity were recorded from patient chart. Length of stay was modeled with mixed effects negative binomial regression and pediatric intensive care unit (PICU) admission with mixed effects logistic regression with random intercept at the census tract and adjustment for clinical factors. A total of 417 infants had median age of 144 days (interquartile range (IQR): 61, 357) and 136 (33%) were born premature. Median LOS was 62 hours (24, 136) with 97 (23%) patients admitted to the PICU. Median household members were 4 (4, 5). For each increase in household member, there was 7% increase in LOS (incidence rate ratio 1.07, 95% confidence interval: 1-1.14, = .038). Social Vulnerability Composite Index, subcategories, insurance status, estimated income, percent of minority, and percent of poverty did not show any associations with length of hospitalization or PICU admission. Increasing number of household members may be associated with increased bronchiolitis hospital LOS. We find no associations with other SES measures.
目前尚不清楚社会经济地位(SES)因素是否会影响毛细支气管炎住院患者的疾病严重程度。本研究旨在确定 SES 因素,包括疾病控制与预防中心的社会脆弱性综合指数(SVI)、估计收入、少数族裔比例、生活贫困比例、保险状况以及与住院时间( LOS )和重症监护病房(PICU)入院相关的家庭人数。使用国际疾病分类代码识别在三级城市中心因毛细支气管炎住院的婴儿。从家庭地址中识别出联邦信息处理系统代码,并将其与 SVI 和 2018 年的普查区配对。从联邦金融机构检查委员会获得其他 SES 措施。从患者图表中记录家庭人数、保险、年龄、性别和早产史。采用混合效应负二项回归模型对 LOS 进行建模,采用混合效应逻辑回归模型对 PICU 入院进行建模,在普查区采用随机截距,并对临床因素进行调整。共有 417 名婴儿,中位数年龄为 144 天(四分位距(IQR):61,357),136 名(33%)为早产儿。中位 LOS 为 62 小时(24,136),97 名(23%)患者入住 PICU。中位数家庭人数为 4(4,5)。家庭人数每增加 1 人, LOS 增加 7%(发病率比 1.07,95%置信区间:1-1.14,=.038)。社会脆弱性综合指数、亚类、保险状况、估计收入、少数民族比例和贫困比例与住院时间或 PICU 入院均无关联。家庭人数的增加可能与毛细支气管炎住院时间的延长有关。我们发现与其他 SES 措施没有关联。