Research Appraisalobservational

Age-Specific Trends and Health Status of Children Aged 12-19 Years with Specified Chronic Pediatric Diseases in Japan - Insights from a National Database Study

The Tohoku journal of experimental medicineKuwahara, Erika, Moriichi, Akinori, Kato, Hitoshi8 Apr 2026DOI

Clinical Snapshot

65CEBM
Evidence: Moderateobservational

PICO Framework

P — PopulationChildren aged 0-19 years with chronic diseases registered in Japan's Specified Chronic Pediatric Diseases program (SCPDJ), with focus on 12-19 year age group
I — InterventionNot applicable (observational study)
C — ComparatorAge-based comparisons across different chronic disease categories and onset patterns
O — OutcomesAge distribution patterns, disease onset characteristics, health status trends, and transition care implications for adolescents aged 12-19 years

Bottom Line

This cross-sectional analysis of Japan's national chronic paediatric disease registry (69,061 cases) identified four distinct age-onset distribution patterns across disease categories and found that approximately half of adolescents aged 12-19 years were diagnosed after school age. While the study provides valuable epidemiological insights into chronic paediatric diseases and highlights the importance of transition care planning, the cross-sectional design limits causal inference. The findings may inform transition care strategies, though direct applicability to Australian healthcare settings requires consideration of system differences. The study's strength lies in its comprehensive national database, but methodological details regarding health status assessment and statistical analysis are limited in the available abstract.

Evidence: Moderate

Key Findings

  • P Value: Not reported in abstract

  • Effect Size: Four distinct age-onset distribution patterns identified across disease categories

  • Primary Outcome: Age distribution patterns and health status of children with chronic diseases in Japan's national registry

  • Nnt Or Sensitivity: Approximately 50% of patients aged 12-19 years diagnosed after reaching school age

  • Confidence Interval: Not reported in abstract

Clinical Application

Descriptive findings may inform transition care planning, though specific interventions not evaluated Limited direct applicability due to different healthcare systems, though transition care principles relevant to Australian paediatric chronic disease management and potential PBS considerations Children and adolescents with chronic diseases requiring transition from paediatric to adult care

Abstract

Japan has a national financial assistance program called the "Specified Chronic Pediatric Diseases of Japan" (SCPDJ; also called "Shouman" in Japanese) for children with chronic diseases designated by the Japanese Ministry of Health, Labour and Welfare. The information of registrants in the system is digitized for research. We utilized the database to clarify the characteristics of children with diseases designated by the SCPDJ program. Analysis was performed with a particular focus on patients aged 12-19 years, which are considered the important ages for transition support from pediatric to adult medical care. The data included 69,061 cases aged 0 to 19 years from April 2016 to March 2017. The number of registrants showed a cumulative increase from 2 years toward adulthood. There were four distribution patterns for registered age and age at onset by disease category: 1) both age and age of onset peaked at age 0; 2) age distribution was mostly flat, while the most common age of onset was age 0; 3) age distribution peaked in older age groups, while age of onset of 0 was most common; and 4) both age and age of onset peaked at older ages. Approximately half of the patients aged 12-19 years were diagnosed after reaching school age. Although the disease condition of most patients remained good, some aged 12-19 years experienced exacerbation. The database was analyzed to provide an overview of children with diseases designated by the SCPDJ program and issues related to transition to adult care systems.

References

  1. 1.Kuwahara, E., Moriichi, A., & Kato, H. (2026). Age-specific trends and health status of children aged 12-19 years with specified chronic pediatric diseases in Japan - insights from a national database study. Tohoku Journal of Experimental Medicine. https://doi.org/10.1620/tjem.2025.J073
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