Prevalence of medical technology assistance among children in Massachusetts in 1987 and 1990.

In 1987 and 1990 in Massachusetts, surveys were conducted to determine the size, pattern of distribution, and trends in the population of children assisted by medical technology. The authors obtained an unduplicated count of all Massachusetts children from 3 months to 18 years of age who used one or more of the following: tracheostomy, respirator, oxygen, suctioning, gastrostomy, jejunal or nasogastric feedings, ostomies, urethral catheterization, ureteral diversion, intravenous access, or dialysis. By comparing counts obtained from medical and educational sources, the authors were able to perform a capture-recapture analysis to estimate the overall number of children dependent upon these technologies. The number of children identified in our surveys increased from 1,085 in 1987 to 1,540 in 1990. However, the capture-recapture analysis yielded estimates of 2,147 plus or minus 230 for 1987 and 2,237 plus or minus 131 for 1990. This suggests that the population of children dependent upon medical technology was essentially stable during this period, and that the 42 percent increase in the number of children identified in our survey reflected improved sampling techniques. During the 3 years, shifts in the pattern of technology use were noted, however. Use of oxygen and gastrostomy increased, and urostomy use declined. A change in the age distribution of the children was also documented, with a shift in the preponderence of technology use from 12 to 24 months in 1987 to children in the first year of life in 1990. Using the 1990 estimate and the 1990 U.S. census figures, an overall prevalence estimate of 0.16 percent was calculated. Applying this to the U.S.child population yields an estimate of 101,800 children assisted by medical technology nationwide(assuming comparable technology use in other States). This information will facilitate policy analysis and program planning on regional and national levels for this medically complex group of children.

1987年和1990年在马萨诸塞州进行了调查，以确定依靠医疗技术辅助的儿童群体的规模、分布模式和趋势。作者对马萨诸塞州所有3个月至18岁使用以下一种或多种医疗手段的儿童进行了无重复计数：气管切开术、呼吸器、氧气、吸痰、胃造口术、空肠或鼻胃管喂食、造口术、尿道插管、输尿管改道、静脉通路或透析。通过比较从医疗和教育来源获得的数据，作者能够进行捕获 - 再捕获分析，以估计依赖这些技术的儿童总数。我们的调查中确定的儿童数量从1987年的1085人增加到1990年的1540人。然而，捕获 - 再捕获分析得出1987年的估计数为2147 ± 230人，1990年为2237 ± 131人。这表明在此期间依赖医疗技术的儿童群体基本稳定，我们调查中确定的儿童数量增加42%反映了抽样技术的改进。然而，在这3年期间，注意到技术使用模式发生了变化。氧气和胃造口术的使用增加，而泌尿造口术的使用减少。还记录了儿童年龄分布的变化，技术使用的优势从1987年的12至24个月转移到1990年的1岁以下儿童。利用1990年的估计数和1990年美国人口普查数据，计算出总体患病率估计为0.16%。将此应用于美国儿童人口，得出全国范围内约有101800名儿童依靠医疗技术辅助（假设其他州的技术使用情况具有可比性）。这些信息将有助于在地区和国家层面针对这一医疗情况复杂的儿童群体进行政策分析和项目规划。