Long-term Out-of-Hospital Health Care Use for Fontan Survivors Across Childhood.

Autor:	Huang L; Centre for Health Policy, The University of Melbourne, Melbourne, Australia., Dalziel KM; Centre for Health Policy, The University of Melbourne, Melbourne, Australia., du Plessis K; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia., Winlaw DS; Department of Paediatric Cardiac Surgery, The Children's Hospital at Westmead, Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia., Cordina R; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia., Pflaumer A; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Cardiology, Royal Children's Hospital, Melbourne, Australia., Justo RN; Paediatric Cardiology, Queensland Children's Hospital, Brisbane, Australia., Wheaton GR; Department of Cardiology, Women's and Children's Hospital, Adelaide, Australia., Bullock A; Paediatric and Adult Congenital Cardiology, Perth Children's Hospital, Perth, Australia; Department of Cardiology, Sir Charles Gairdner Hospital, Perth, Australia., Verrall CE; Sydney Medical School, The University of Sydney, Sydney, Australia; The Heart Centre for Children, The Children's Hospital at Westmead, Sydney, Australia., d'Udekem Y; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia. Electronic address: yves.dudekem@rch.org.au.
Jazyk:	angličtina
Zdroj:	The Annals of thoracic surgery [Ann Thorac Surg] 2020 Oct; Vol. 110 (4), pp. 1372-1378. Date of Electronic Publication: 2020 Feb 28.
DOI:	10.1016/j.athoracsur.2020.01.030
Abstrakt:	Background: Surgery is the cornerstone of treatment for single-ventricle patients, but life just begins for most when the staged procedures are completed. A package of care, including primary care, out-of-hospital specialist visits, and medication, is required for patients living with Fontan. This study quantified the current state of out-of-hospital health care use across childhood for Fontan patients using evidence from Australia. Methods: Patients recruited from the Fontan Registry were linked with the administrative Medicare (universal health insurance) data. Frequency of medical and pharmaceutical care and costs were estimated. Results: Data for 115 patients with 12,726 medical and 8,336 pharmaceutical claims were obtained. From age 0 to 20 years, patients on average visited a general practitioner an estimated 6.4 times per year (95% confidence interval [CI], 5.9-7.0 times per year), and specialists, including cardiologists, 2.8 times per year (95% CI, 2.5-3.0 times per year). Average use of allied health professional care peaked at age 6 to 9 years (1.0 visits per year; 95% CI, 0.7-1.4 visits per year) with psychologic services being most prominent. For pharmaceuticals, an average of 13.3 prescriptions filled per patient per year throughout childhood was observed (95% CI, 12.4-14.2 prescriptions per year). Overall, out-of-hospital doctor visits of all types averaged 11 visits per year from birth to 20 years. A decline in care was observed when patients reached 18 years across services. Conclusions: Patterns of out-of-hospital health care use were observed; however, current guidelines are silent about whether this is optimal. Further research is needed to better understand the comprehensive needs of this population. (Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu