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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Variation in specialty care hospitalization for children with chronic conditions in California.
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Variation in specialty care hospitalization for children with chronic conditions in California.

机译：加利福尼亚州患有慢性疾病的儿童的特殊护理住院情况有所不同。

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OBJECTIVE: Despite the documented utility of regionalized systems of pediatric specialty care, little is known about the actual use of such systems in total populations of chronically ill children. The objective of this study was to evaluate variations and trends in regional patterns of specialty care hospitalization for children with chronic illness in California. METHODS: Using California's Office of Statewide Health Planning and Development unmasked discharge data set between 1999 and 2007, we performed a retrospective, total-population analysis of variations in specialty care hospitalization for children with chronic illness in California. The main outcome measure was the use of pediatric specialty care centers for hospitalization of children with a chronic condition in California. RESULTS: Analysis of 2 170 102 pediatric discharges revealed that 41% had a chronic condition, and 44% of these were discharged from specialty care centers. Specialty care hospitalization varied by county and type of condition. Multivariate analyses associated increased specialty care center use with public insurance and high pediatric specialty care bed supply. Decreased use of regionalized care was seen for adolescent patients, black, non-Hispanic children, and children who resided in zip codes of low income or were located farther from a regional center of care. CONCLUSIONS: Significant variation exists in specialty care hospitalization among chronically ill children in California. These findings suggest a need for greater scrutiny of clinical practices and child health policies that shape patterns of hospitalization of children with serious chronic disease.
机译：目的：尽管有文献记载了儿科专科护理区域化系统的实用性，但对于在慢性病儿童总数中实际使用这种系统知之甚少。这项研究的目的是评估加利福尼亚州慢性病患儿的特殊护理住院区域模式的变化和趋势。方法：我们使用了加利福尼亚州州立卫生计划与发展办公室（1999年至2007年）的非公开出院数据集，对加利福尼亚州慢性病患儿的特殊护理住院变化进行了回顾性总人口分析。主要结局指标是在加利福尼亚州使用儿科专科护理中心住院治疗患有慢性疾病的儿童。结果：对2 170 102例儿科出院的分析表明，41％患有慢性病，其中44％是从专科护理中心出院的。专业护理住院因县和病情类型而异。多变量分析将增加的专科护理中心与公共保险和小儿专科护理床的供应联系起来。青少年患者，黑人，非西班牙裔儿童以及居住在低收入邮政编码或距离区域护理中心较远的儿童，使用区域护理的情况有所减少。结论：在加利福尼亚州的慢性病儿童中，在特殊护理住院方面存在显着差异。这些发现表明，需要对构成严重慢性疾病儿童住院模式的临床实践和儿童健康政策进行更严格的审查。

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