Tilman Brand, Paula Herrera-Espejel, Saskia Muellmann, Rebekka Wiersing, Heide Busse
[Social inequality in the context of digital health applications: digital divides in access, use, effectiveness, and privacy]
Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
comprehensive multicenter data treatment pediatric moyamoya united states lacking sought identify national trends diagnosis treatment disease total 2454 moyamoya admissions 1997 2012 identified kids inpatient database demographics inpatient costs interventions discharge status analyzed admissions without surgical revascularization reviewed separately effect hospital moyamoya volume outcomes analyzed multivariate regression analysis care moyamoya patients concentrating highvolume centers past 12 years among moyamoya admission without surgical revascularization highvolume hospitals show difference length stay cost complications compared lowvolume centers however lowvolume hospitals nonroutine discharges odds ratio 232 p00005 inpatient deaths odds ratio 127 p002 revascularization performed contrast among admissions surgical revascularization highvolume centers decreased length stay 47 versus 62 days p0004 reduced cost 88 000 versus 138 000 p00001 increase complications p029 compared lowvolume centers admissions revascularization lowvolume hospitals also increased likelihood nonroutine discharge odds ratio 823 p002 compared highvolume centers largest study us pediatric moyamoya admissions date data demonstrate volume correlates outcome indicating highvolume centers provide significantly improved care reduced mortality pediatric moyamoya patients marked benefit observed admissions surgical revascularization