Clinical Outcomes and Medical Costs of Hospitalized Children Requiring Daily Medical Care in Japan.

IF 3.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Osamu Matsumura Momo, Susumu Kunisawa, Kenji Kishimoto, Kiyohide Fushimi, Yuichi Imanaka
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Abstract

BackgroundThis study aimed to describe the clinical outcomes and medical costs of hospitalized children requiring daily medical care (CRDMC), a patient group for which government-led support has developed rapidly in Japan.MethodsA retrospective longitudinal study was conducted using a nationwide administrative database. All hospitalizations of children aged under 18 years discharged from April 2014 to March 2021 were included. Clinical outcomes and medical costs were compared between CRDMC and non-CRDMC hospitalizations. The estimated increase in the proportion of CRDMC medical costs among all pediatric hospitalizations during the study period was also calculated.ResultsAmong the 1,531,456 hospitalizations included, 91,413 were identified as CRDMC. CRDMC accounted for 3.7% of the annual unique inpatients. The 30-day readmission rate among CRDMC was 27.5%, and the rate among those receiving multiple types of medical care was higher at 33.7%. The inpatient medical cost of CRDMC accounted for 20.3% of pediatric inpatient medical costs, with an estimated rise of 1.2881 (95% CI, 1.2110-1.3702) during the study period. In the breakdown of the medical costs, the proportion of injection drug fees increased most rapidly.ConclusionsThe high 30-day readmission rate in CRDMC was distinctive among the clinical outcomes. The proportion of medical costs for CRDMC in pediatric inpatients was high, although CRDMC accounted for only a small proportion of annual unique inpatients. Further support for CRDMC must be based on the unique characteristics of this population.

日本住院儿童需要日常医疗护理的临床结果和医疗费用
本研究旨在描述需要日常医疗护理的住院儿童(CRDMC)的临床结果和医疗费用,这是日本政府主导的支持迅速发展的患者群体。方法采用全国行政数据库进行回顾性纵向研究。包括2014年4月至2021年3月期间出院的所有18岁以下住院儿童。比较CRDMC和非CRDMC住院患者的临床结果和医疗费用。在研究期间,还计算了所有儿科住院治疗中CRDMC医疗费用的估计增加比例。结果在纳入的1531456例住院患者中,91413例被确定为CRDMC。CRDMC占全年唯一住院患者的3.7%。CRDMC患者30天再入院率为27.5%,接受多种医疗服务的患者30天再入院率较高,为33.7%。CRDMC的住院医疗费用占儿科住院医疗费用的20.3%,估计在研究期间上升了1.2881 (95% CI, 1.2110-1.3702)。在医疗费用的分类中,注射药品费用占比增长最快。结论CRDMC患者30天再入院率高在临床结果中具有显著性。CRDMC在儿科住院患者中所占的医疗费用比例很高,尽管CRDMC仅占年度唯一住院患者的一小部分。对CRDMC的进一步支持必须基于这一群体的独特特征。
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来源期刊
Journal of Epidemiology
Journal of Epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.50
自引率
4.30%
发文量
172
审稿时长
6-12 weeks
期刊介绍: The Journal of Epidemiology is the official open access scientific journal of the Japan Epidemiological Association. The Journal publishes a broad range of original research on epidemiology as it relates to human health, and aims to promote communication among those engaged in the field of epidemiological research and those who use epidemiological findings.
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