Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
J Hosp Med. 2024 Jun;19(6):495-504. doi: 10.1002/jhm.13322. Epub 2024 Mar 22.
Young adults (YA) with childhood-onset chronic conditions-particularly YA with cystic fibrosis (CF), congenital heart disease (CHD), and sickle cell disease (SCD)-continue to have pediatric hospital admissions. Factors associated with this continued pediatric hospital use remain underexplored.
To determine if pediatric hospital use by YA differed (1) across condition and (2) within each condition by sociodemographic factors.
Conducted a cross-sectional analysis of admissions for YA 22-35 years with CF, CHD, and SCD from 2016 to 2020 in the National Inpatient Sample. Admissions for YA with CF, CHD, and SCD were identified by international classification of diseases, 10th revision-clinical modification diagnosis codes. To determine if conditions or sociodemographic factors were associated with YA pediatric hospital use, we used multivariable logistic regression with separate models for the different objectives.
YA with SCD had lower odds of pediatric hospital use compared to YA with CF. Relationships between sociodemographic factors and pediatric hospital use varied. Black YA with both CF and CHD had lower odds of pediatric hospital use than white YA with CF and CHD. For YA with SCD, despite 17,810 (6.5%) having rural residence, zero (0) had pediatric hospital use; whereas YA with CF living in a rural area had greater odds of pediatric hospital use compared to urban residents.
YA with SCD used pediatric hospitals less than YA with either CF or CHD. Coupled with our findings that Black YA with CF and CHD had less pediatric hospital use, these data may reflect systematic racial differences within pediatric to adult healthcare transition programs.
患有儿童期起病的慢性疾病的年轻人（YA）——尤其是患有囊性纤维化（CF）、先天性心脏病（CHD）和镰状细胞病（SCD）的 YA——仍需住院治疗。与这种持续的儿科住院使用相关的因素仍未得到充分探索。
确定 YA 的儿科住院使用情况是否存在差异（1）在不同疾病之间，以及（2）在每种疾病内是否存在社会人口统计学因素。
对 2016 年至 2020 年国家住院患者样本中 22-35 岁患有 CF、CHD 和 SCD 的 YA 的住院情况进行了横断面分析。通过国际疾病分类第 10 次修订临床修正诊断代码识别患有 CF、CHD 和 SCD 的 YA 的住院情况。为了确定疾病或社会人口统计学因素是否与 YA 儿科住院使用相关，我们使用多变量逻辑回归，针对不同的目标分别建立模型。
与患有 CF 的 YA 相比，患有 SCD 的 YA 儿科住院使用的可能性较低。社会人口统计学因素与儿科住院使用之间的关系各不相同。患有 CF 和 CHD 的黑人 YA 比患有 CF 和 CHD 的白人 YA 儿科住院使用的可能性较低。对于患有 SCD 的 YA，尽管有 17810 人（6.5%）居住在农村地区，但没有人（0）使用儿科医院；而居住在农村地区的患有 CF 的 YA 比城市居民更有可能使用儿科医院。
与患有 CF 或 CHD 的 YA 相比，患有 SCD 的 YA 使用儿科医院的频率较低。再加上我们发现患有 CF 和 CHD 的黑人 YA 儿科住院使用频率较低，这些数据可能反映了儿科到成人医疗过渡项目中存在系统的种族差异。
