Health Care Resource Utilization and Costs Associated with Childhood Hypertension: A Population-Based Cohort Study
Notice bibliographique
Résumé
Background: Pediatric hypertension has risen significantly in recent decades and has been linked to long-term cardiovascular and kidney-related morbidity. However, healthcare resource utilization and costs associated with pediatric hypertension are unclear. This study aims to compare healthcare resource use and costs between children with and without hypertension. Methods: Population-based retrospective cohort study of children aged 3-18 years diagnosed with hypertension from 1996 to 2021 in Ontario, Canada, using validated case definitions in health administrative databases. Each case was propensity score-matched with five controls without hypertension. Children were followed until death, provincial emigration, or March 31, 2022. Our primary outcome was rates of healthcare system utilization, including hospitalizations, emergency department(ED), and outpatient physician visits, analyzed by negative binomial regression. Secondary outcomes were total healthcare system costs and specialist physician follow-up. Results: We matched 25,605 children diagnosed with hypertension to 128,025 non-hypertensive controls. Baseline covariates were balanced after propensity score matching. Median age was 15 years[IQR 11-17], 49% were female, and prior comorbidities were uncommon(1% congenital heart disease, 1.7% malignancy, 0.4% diabetes). During median 12.9-year[IQR 6.8-19.9] follow-up, hypertensive children were more likely to be hospitalized(rate ratio [RR] 2.13, 95%CI 2.03-2.22, incidence rate [IR] 105.5 vs 62.8 events per 1000 person-years). Hypertensive children were also more likely to have an ED visit(RR 1.08, 95%CI 1.05-1.11) and outpatient visit(RR 1.33, 95%CI 1.31-1.34). Within 1 year of hypertension diagnosis, 40% of children saw a pediatrician, 24% saw a cardiologist, and 5% saw a nephrologist. Hypertension was associated with substantially higher total healthcare costs throughout follow-up(median $1375 vs. $384 per person-year). Conclusion: Healthcare utilization and costs were significantly higher among children and adolescents diagnosed with hypertension than matched non-hypertensive children. These results provide a basis for future cost-effectiveness studies of strategies to prevent childhood hypertension occurrence and late complications.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».