Epidemiology of Children With Multiple Complex Chronic Conditions in a Mixed Urban-Rural US Community
| Autor: | Euijung Ryu, Young J. Juhn, Sheri Crow, Kara A. Bjur, Chung-Il Wi, Katherine S. King |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Rural Population medicine.medical_specialty Adolescent Urban Population Cross-sectional study Minnesota Prevalence Child Welfare Intensive Care Units Pediatric Pediatrics 03 medical and health sciences 0302 clinical medicine Rochester Epidemiology Project 030225 pediatrics Health care Epidemiology Humans Medicine Multiple Chronic Conditions 030212 general & internal medicine Child Socioeconomic status Research Articles Primary Health Care business.industry Incidence Incidence (epidemiology) Infant General Medicine Health equity Cross-Sectional Studies Social Class Child Preschool Pediatrics Perinatology and Child Health Female business Demography |
| Zdroj: | Hospital Pediatrics. 9:281-290 |
| ISSN: | 2154-1671 2154-1663 |
| DOI: | 10.1542/hpeds.2018-0091 |
| Popis: | OBJECTIVES:Children with multiple complex chronic conditions (MCCs) represent a small fraction of our communities but a disproportionate amount of health care cost and mortality. Because the temporal trends of children with MCCs within a geographically well-defined US pediatric population has not been previously assessed, health care planning and policy for this vulnerable population is limited.METHODS:In this population-based, repeated cross-sectional study, we identified and enrolled all eligible children residing in Olmsted County, Minnesota, through the Rochester Epidemiology Project, a medical record linkage system of Olmsted County residents. The pediatric complex chronic conditions classification system version 2 was used to identify children with MCCs. Five-year period prevalence and incidence rates were calculated during the study period (1999–2014) and characterized by age, sex, ethnicity, and socioeconomic status (SES) by using the housing-based index of socioeconomic status, a validated individual housing-based SES index. Age-, sex-, and ethnicity-adjusted prevalence and incidence rates were calculated, adjusting to the 2010 US total pediatric population.RESULTS:Five-year prevalence and incidence rates of children with MCCs in Olmsted County increased from 1200 to 1938 per 100 000 persons and from 256 to 335 per 100 000 person-years, respectively, during the study period. MCCs tend to be slightly more prevalent among children with a lower SES and with a racial minority background.CONCLUSIONS:Both 5-year prevalence and incidence rates of children with MCCs have significantly increased over time, and health disparities are present among these children. The clinical and financial outcomes of children with MCCs need to be assessed for formulating suitable health care planning given limited resources. |
| Databáze: | OpenAIRE |
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