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新冠疫情、倦怠和药物短缺:美国医疗系统运转失灵,儿童和家长深受其害

ELLEN DASILVA
2022-12-20

儿科医院、急诊科的儿科科室以及以儿科为基础的紧急医疗诊所等,都在以惊人的速度减少。这种现象早在疫情之前就已经开始。

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疫情使儿科病房和诊所的数量加速稳步减少。图片来源:JOEL LERNER - XINHUA - GETTY IMAGES

每次走进我在曼哈顿的儿科诊所,我都对人们深感同情。诊所里人手不足,所有人都在连轴转,而孩子们的医疗需求不断增加。

过去三年,随着疫情持续肆虐,无论是疫苗还是其他治疗方法都忽视了儿童这个群体,而儿科医生们为孩子们所做的一切堪称奇迹。然而,在整个社会,我们对儿科健康的忽视,却不利于家长、儿童和整个医学体系。

作为一家儿科远程医疗平台的CEO,我很不幸见证了整个医疗体系以惊人的速度,不断令家长们失望。我经常想起家长们每年要拿出大量工作时间,照顾生病的孩子。

我看到了学校停课,因为学校有32%的人感染了流感。我还想到了家长们在每次就诊平均2,032美元的紧急医疗护理与养家糊口之间的艰难权衡。

医疗体系并不认为儿科医疗有利可图,并且正在减少儿科病房和诊所的数量

儿科医院、急诊科的儿科科室以及以儿科为基础的紧急医疗诊所等,都在以惊人的速度减少。这种现象早在疫情之前就已经开始。

美国儿科学会(American Academy of Pediatrics)估计,2008年至2018年期间,儿科住院病房减少了约20%。新冠疫情加快了这个趋势,因为医院将儿科科室改造成成人紧急护理中心,用于治疗老年新冠患者。

不幸的是,这种趋势归根结底在于经济学因素。医疗体系意识到,老年患者或成年患者住院所带来的收入超过儿童患者。因此,偏远地区的家长不得不跨州甚至驾车八个小时,为孩子获得持续的医疗护理。这种现象的根源在于,儿童从医疗补助(Medicaid)和儿童医疗保险计划(CHIP)获得的赔付率更低,这两个系统覆盖了美国超过40%的儿童。此外,成年人的检测和治疗过程费用更高。

新冠疫情和减员加剧了医疗体系的紧张

过去三年,医疗体系承受了巨大压力,造成医院病房和医疗服务提供商短缺。面对可能发生的经济衰退,经济上的种种困境导致在疫情期间经历过紧张状况的许多医院和医疗护理提供商,在财务上很难恢复元气。

除了儿科治疗资源减少以外,儿童还尤其容易受到常见病症的影响,特别是呼吸道合胞病毒和流感,因为他们在过去两个冬季并没有被暴露于这些疾病。今年,儿童感染率上升了超过30%,而对乙酰氨基酚、布洛芬、阿莫西林和奥司他韦等治疗呼吸道疾病的主要药物都缺少儿科用药。医院病床短缺和医生的职业倦怠,导致医疗体系无法满足家长们为孩子们寻求治疗的需求。

约20%的美国人在疫情期间推迟了接受某些医疗护理的时间。结果,随着病情恶化,人们决定继续接受他们一直以来忽视的治疗,使医疗体系依旧承受着过重的压力。

迫在眉睫的心理健康危机影响儿童和看护人员

发生在青少年当中的心理健康危机并不新鲜。2010年至2020年十年间,青少年自杀率稳步升高。然而,疫情严重加剧了这个趋势。无法与朋友见面、日益加剧的不平等、缺少儿童看护和对健康的恐慌,给儿童和家长带来了不可逆转的影响。

5至11岁的儿童因为儿科心理健康问题前往急诊科的比例提高了24%,12至17岁儿童的比例提高了31%,这也增加了急诊医疗服务体系的工作量。

医生加入大辞职浪潮

医生开始感受到在一线持续奋战三年的影响。毫不意外,有五分之一医生表示计划在2023年底前辞职。儿科医生尤其存在严重的倦怠现象:超过61%的儿科医生表示过去三年在工作中的持续恐慌状态,令他们感觉不堪重负。

儿科医疗的困境不可避免。儿科医生的供应不足与患儿的父母对儿科医疗的需求之间的不匹配,将令医疗体系难以承受。别无选择的家长们不得不选择更昂贵的医疗方案,包括接受紧急护理或前往急诊室。

我依旧保持乐观。新的解决方案和技术既能提供获得医疗护理的方便途径,又能为儿科医生提供一种更可持续的工作环境。我们可以专注于创新,提供下一代医疗健康服务,同时让家长们保持清醒的头脑。(财富中文网)

本文作者艾伦·达斯维拉是Summer Health的创始人兼CEO,该公司提供基于信息的儿科医疗服务,她还参与出版了《游说与交易:关于业务开发、合作和达成重要交易的指南》(Pitching & Closing: Everything You Need To Know About Business Development, Partnerships, and Making Deals that Matter)一书。

Fortune.com上发表的评论文章中表达的观点,仅代表作者本人的观点,并不代表《财富》杂志的观点和立场。

译者:刘进龙

审校:汪皓

每次走进我在曼哈顿的儿科诊所,我都对人们深感同情。诊所里人手不足,所有人都在连轴转,而孩子们的医疗需求不断增加。

过去三年,随着疫情持续肆虐,无论是疫苗还是其他治疗方法都忽视了儿童这个群体,而儿科医生们为孩子们所做的一切堪称奇迹。然而,在整个社会,我们对儿科健康的忽视,却不利于家长、儿童和整个医学体系。

作为一家儿科远程医疗平台的CEO,我很不幸见证了整个医疗体系以惊人的速度,不断令家长们失望。我经常想起家长们每年要拿出大量工作时间,照顾生病的孩子。

我看到了学校停课,因为学校有32%的人感染了流感。我还想到了家长们在每次就诊平均2,032美元的紧急医疗护理与养家糊口之间的艰难权衡。

医疗体系并不认为儿科医疗有利可图,并且正在减少儿科病房和诊所的数量

儿科医院、急诊科的儿科科室以及以儿科为基础的紧急医疗诊所等,都在以惊人的速度减少。这种现象早在疫情之前就已经开始。

美国儿科学会(American Academy of Pediatrics)估计,2008年至2018年期间,儿科住院病房减少了约20%。新冠疫情加快了这个趋势,因为医院将儿科科室改造成成人紧急护理中心,用于治疗老年新冠患者。

不幸的是,这种趋势归根结底在于经济学因素。医疗体系意识到,老年患者或成年患者住院所带来的收入超过儿童患者。因此,偏远地区的家长不得不跨州甚至驾车八个小时,为孩子获得持续的医疗护理。这种现象的根源在于,儿童从医疗补助(Medicaid)和儿童医疗保险计划(CHIP)获得的赔付率更低,这两个系统覆盖了美国超过40%的儿童。此外,成年人的检测和治疗过程费用更高。

新冠疫情和减员加剧了医疗体系的紧张

过去三年,医疗体系承受了巨大压力,造成医院病房和医疗服务提供商短缺。面对可能发生的经济衰退,经济上的种种困境导致在疫情期间经历过紧张状况的许多医院和医疗护理提供商,在财务上很难恢复元气。

除了儿科治疗资源减少以外,儿童还尤其容易受到常见病症的影响,特别是呼吸道合胞病毒和流感,因为他们在过去两个冬季并没有被暴露于这些疾病。今年,儿童感染率上升了超过30%,而对乙酰氨基酚、布洛芬、阿莫西林和奥司他韦等治疗呼吸道疾病的主要药物都缺少儿科用药。医院病床短缺和医生的职业倦怠,导致医疗体系无法满足家长们为孩子们寻求治疗的需求。

约20%的美国人在疫情期间推迟了接受某些医疗护理的时间。结果,随着病情恶化,人们决定继续接受他们一直以来忽视的治疗,使医疗体系依旧承受着过重的压力。

迫在眉睫的心理健康危机影响儿童和看护人员

发生在青少年当中的心理健康危机并不新鲜。2010年至2020年十年间,青少年自杀率稳步升高。然而,疫情严重加剧了这个趋势。无法与朋友见面、日益加剧的不平等、缺少儿童看护和对健康的恐慌,给儿童和家长带来了不可逆转的影响。

5至11岁的儿童因为儿科心理健康问题前往急诊科的比例提高了24%,12至17岁儿童的比例提高了31%,这也增加了急诊医疗服务体系的工作量。

医生加入大辞职浪潮

医生开始感受到在一线持续奋战三年的影响。毫不意外,有五分之一医生表示计划在2023年底前辞职。儿科医生尤其存在严重的倦怠现象:超过61%的儿科医生表示过去三年在工作中的持续恐慌状态,令他们感觉不堪重负。

儿科医疗的困境不可避免。儿科医生的供应不足与患儿的父母对儿科医疗的需求之间的不匹配,将令医疗体系难以承受。别无选择的家长们不得不选择更昂贵的医疗方案,包括接受紧急护理或前往急诊室。

我依旧保持乐观。新的解决方案和技术既能提供获得医疗护理的方便途径,又能为儿科医生提供一种更可持续的工作环境。我们可以专注于创新,提供下一代医疗健康服务,同时让家长们保持清醒的头脑。(财富中文网)

本文作者艾伦·达斯维拉是Summer Health的创始人兼CEO,该公司提供基于信息的儿科医疗服务,她还参与出版了《游说与交易:关于业务开发、合作和达成重要交易的指南》(Pitching & Closing: Everything You Need To Know About Business Development, Partnerships, and Making Deals that Matter)一书。

Fortune.com上发表的评论文章中表达的观点,仅代表作者本人的观点,并不代表《财富》杂志的观点和立场。

译者:刘进龙

审校:汪皓

I have deep sympathy every time I walk into my children’s pediatric practice in Manhattan. The place seems short-staffed, everyone is working around the clock, and the needs of our kids continue to mount.

What pediatricians have done for our children over the last three years, as the pandemic raged on and kids continued to be overlooked for vaccines and other remedies, is nothing short of a miracle. However, as a society, we’re ignoring pediatric health to the detriment of parents, kids, and medicine as a whole.

In my role as the CEO of a pediatric telehealth platform, I’ve had the unfortunate reality of witnessing the system continue to fail our parents at an alarming rate. I’m constantly reminded of the countless hours parents spend away from work every year to take care of a sick child.

I see school closures taking place because 32% of the school population has the flu. And I think about the impossible tradeoff parents have to make between getting urgent medical care for an average of $2,032 per visit, or feeding their families.

Health systems do not find pediatric care lucrative and are downsizing pediatric units and practices

Pediatric hospitals, children’s floors in emergency departments, and peds-based urgent medicine practices are shrinking at an alarming rate. This is a phenomenon that began well before the pandemic.

The American Academy of Pediatrics estimates that between 2008-2018, pediatric inpatient units shrank by almost 20%. The pandemic exacerbated this trend, as hospitals converted children’s floors into adult urgent care centers to treat older patients for COVID.

The unfortunate reality is that it comes down to economics. Health systems realize that they can generate more income on a bed filled with an elderly patient or an adult rather than with a child. As a result, parents in rural areas are forced to drive across state lines or for up to eight hours to get consistent medical care for their children. This phenomenon stems from the fact that reimbursement rates are lower for children from Medicaid and CHIP, which cover over 40% of children in the U.S. Additionally, adults are subject to more expensive tests and procedures.

COVID and cutbacks caused immense strain on the medical system

The last three years have put tremendous strain on the healthcare system, resulting in a shortage of hospital beds and providers. As we stare into a likely downturn, economic headwinds have made it difficult for many hospitals and healthcare providers to financially recover from the strain they experienced during the pandemic.

In conjunction with downsizing pediatric availability, kids are disproportionately suffering from common conditions, notably RSV and the flu, because they were not exposed to them over the last two winters. Infections were up over 30% this year–and we are facing shortages of pediatric formulations of key medicines such as acetaminophen, ibuprofen, amoxicillin, and Tamiflu to treat respiratory illnesses. Due to hospital bed shortages and physician fatigue, the system is unable to meet the demand from parents seeking care for their children.

Almost 20% of Americans delayed some form of medical care during the pandemic. As a result, the system remains overburdened as these conditions worsened and people decided that they need to catch up on the healthcare they had overlooked.

A brewing mental health crisis is affecting children and carers

The mental health crisis amongst teens isn’t news. Suicide rates among teens climbed steadily over the decade between 2010-2020. However, the pandemic deeply exacerbated this trend. An inability to see friends, rising inequality, lack of childcare, and health scares put irreversible strain on both children and parents.

Visits to emergency departments for pediatric mental health concerns increased by 24% for children aged five to 11 and 31% for children aged 12-17, causing a backlog in our emergency medicine system as well.

Physicians have joined the Great Resignation

Physicians are starting to feel the effects of three years of nonstop frontline work. It’s no surprise that one in five physicians say they plan to resign by the end of 2023. Pediatricians particularly suffer from tremendous burnout: over 61% cite feeling burnt out by a constant state of panic in their role over the last three years.

The crunch for pediatric care is inevitable. The system can’t sustain the mismatch of pediatrician supply and demand from parents for their sick kids. With fewer options, parents are forced to turn to more expensive options for care, including going to urgent care or the emergency room.

I remain optimistic. New solutions and technologies can both offer instant access to medical care and provide a more sustainable working environment for pediatricians. By focusing on innovation, we can provide for the health and wellness of the next generation while maintaining the sanity of their parents.

Ellen DaSilva is the founder and CEO of Summer Health, which offers message-based pediatric medical service, and the co-author of Pitching & Closing: Everything You Need To Know About Business Development, Partnerships, and Making Deals that Matter.

The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.

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