Technology-dependency among patients discharged from a children's hospital: A retrospective cohort study

被引：83

作者：

Feudtner C. ^{[1
,2
]}

Villareale N.L. ^{[3
]}

Morray B. ^{[3
]}

Sharp V. ^{[3
]}

Hays R.M. ^{[4
,5
]}

Neff J.M. ^{[3
,6
]}

机构：

[1] Pediatric Advanced Care Team, Integrated Care Service, The Children's Hospital of Philadelphia, Philadelphia, PA

[2] The Leonard Davis Institute, Center for Bioethics, University of Pennsylvania, Philadelphia, PA

[3] Center for Children with Special Needs, Children's Hospital and Regional Medical Center, Seattle, WA

[4] Pediatric Palliative Care Program, Children's Hospital, Regional Medical Center, Seattle, WA

[5] Department of Rehabilitation Medicine, University of Washington, Seattle, WA

[6] Department of Pediatrics, University of Washington, Seattle, WA

来源：

BMC Pediatrics | / 5卷 / 1期

关键词：

Child With Special Health Care Need; Special Health Care; Clean Intermittent Catheterization; Cerebrospinal Fluid Shunt; Child With Special Health Care Need;

D O I：

10.1186/1471-2431-5-8

中图分类号：

学科分类号：

摘要：

Background: Advances in medical technology may be increasing the population of children who are technology-dependent (TD). We assessed the proportion of children discharged from a children's hospital who are judged to be TD, and determined the most common devices and number of prescription medications at the time of discharge. Methods: Chart review of 100 randomly selected patients from all services discharged from a children's hospital during the year 2000. Data were reviewed independently by 4 investigators who classified the cases as TD if the failure or withdrawal of the technology would likely have adverse health consequences sufficient to require hospitalization. Only those cases where 3 or 4 raters agreed were classified as TD. Results: Among the 100 randomly sampled patients, the median age was 7 years (range: 1 day to 24 years old), 52% were male, 86% primarily spoke English, and 54% were privately insured. The median length of stay was 3 days (range: 1 to 103 days). No diagnosis accounted for more than 5% of cases. 41% were deemed to be technology dependent, with 20% dependent upon devices, 32% dependent upon medications, and 11% dependent upon both devices and medications. Devices at the time of discharge included gastrostomy and jejeunostomy tubes (10%), central venous catheters (7%), and tracheotomies (1%). The median number of prescription medications was 2 (range: 0-13), with 12% of cases having 5 or more medications. Home care services were planned for 7% of cases. Conclusion: Technology-dependency is common among children discharged from a children's hospital. © 2005 Feudtner et al; licensee BioMed Central Ltd.

引用

页数：8

共 25 条

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