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首页> 外文期刊>The Journal of pediatrics >Hospitalizations for Ambulatory Care-Sensitive Conditions among Children with Chronic and Complex Diseases
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Hospitalizations for Ambulatory Care-Sensitive Conditions among Children with Chronic and Complex Diseases

机译：用于慢性和复杂疾病的儿童的外部护理敏感条件住院

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ObjectiveTo evaluate ambulatory-care sensitive (ACS) hospitalizations for children with noncomplex chronic diseases (NC-CD) and children with medical complexity (CMC), and identify associations with ambulatory care characteristics. Although ACS hospitalizations are potentially preventable in general populations, the specific ambulatory care predictors and influence of medical complexity on them is poorly understood. Study designRetrospective cohort study of NC-CD and CMC hospitalizations at a children's hospital during 2007-2014, excluding labor/delivery and children over 21 years. Pediatric medical complexity algorithm identified NC-CD or CMC. ACS hospitalizations were identified using Agency for Healthcare Research and Quality indicator definitions. Demographic and ambulatory care characteristics were compared between ACS and non-ACS hospitalizations with logistic regression clustered by patient. Measures of ambulatory care during 2 years before admission were explored with 20% random sample of general pediatrics discharges. ResultsAmong 4035 children with NC-CD, 14.6% of 4926 hospitalizations were ACS hospitalizations. Among 5084 CMC, 5.3% of 14?390 discharges were ACS hospitalizations. Among NC-CD discharges, ACS hospitalizations were more likely with no prior-year outpatient visits (OR 1.4, 95% CI 1.1-1.7) and less likely with timely well checks (OR 0.8, 95% CI 0.6-0.9) and phone encounters in the month before admission (OR 0.5, 95% CI 0.2-1.0). Among CMC discharges, the only association observed was with provider continuity (OR 0.3, 95% CI 0.1- 1.0). ConclusionsProvider continuity may be associated with fewer CMC ACS hospitalizations, however, measures of ambulatory care were more consistently associated with ACS hospitalizations for NC-CD. CMC may need more precise ACS hospitalization definitions.
机译：ObjectiveTo评估具有非复杂慢性疾病（NC-CD）和具有医疗复杂性（CMC）的儿童的儿童儿童住院（ACS）住院，并识别具有动态护理特征的关联。虽然ACS住院治疗普遍群体可能会阻碍，但具体的外国护理预测因子和医疗复杂性对它们的影响很差。在2007 - 2014年期间研究儿童医院NC-CD和CMC住院的DescriptionRetrosptive队列研究，不包括劳动/交付和21多年的儿童。小儿医学复杂性算法鉴定了NC-CD或CMC。使用医疗保健研究和质量指标定义来确定ACS住院治疗。在ACS和非ACS住院区比较了人口和矛盾护理特征，患者与患者聚集的逻辑回归。在入院前2年探讨了20％的普通儿科排放量探讨了措施。结果4035名患有NC-CD的儿童，占4926家住院的14.6％是ACS住院治疗。在5084厘米中，5.3％的14个？390排放量为ACS住院治疗。在NC-CD排放中，ACS住院的住院更可能在没有先前的门诊访问（或1.4,95％CI 1.1-1.7），并且不太可能及时检查（或0.8,95％CI 0.6-0.9）和电话遭遇在入场前（或0.5,95％CI 0.2-1.0）的月份。在CMC放电中，观察到的唯一关联是提供者连续性（或0.3,95％CI 0.1-1.0）。结论可以与较少的CMC ACS住院关系有关，然而，对于NC-CD的ACS住院，对动态护理的措施更始终如一。 CMC可能需要更精确的ACS住院定义。

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