Importance The US National Institutes of Health (NIH) is the largest government funding source for biomedical research globally. Burden of disease is one of the factors considered by the NIH in making funding allocations, though it is not known how funding patterns are associated with disease burden for pediatric conditions. Objective To determine the correlation between NIH funding and disease burden across pediatric conditions. Design, Setting, and Participants This cross-sectional study evaluates NIH grants funding pediatric research from 2015 to 2018 in the US. Pediatric grants were classified according to disease categories studied. Disease burden for each category was determined using measures from the Institute of Health Metrics and Evaluation and hospitalization data from the 2016 Kids' Inpatient Database. Main Outcome and Measure Correlation between NIH funding and pediatric disease burden using Spearman rank order coefficients and predicted amounts of disease-specific funding based on disease burden estimated from linear regression models. Results This study analyzed 14 060 disease-specific pediatric grants awarded by the NIH from 2015 to 2018 in the US. Annual funding for disease categories ranged from $0 to $382 849 631. Funding for pediatric research was correlated with pediatric disability-adjusted life-years (DALYs), deaths, years lived with disability, and years of life lost (r, 0.56-0.63; P < 0.001 for all measures). There was also a correlation between funding and hospital-based metrics, including hospital days, number of hospital admissions, and hospital charges (r, 0.67-0.69; P < .001 for all measures). Eight disease categories received greater than $500 million more than predicted levels relative to DALYs, while 5 disease categories were funded more than $50 million less than predicted levels. Based on predicted levels of funding, congenital birth defects; endocrine, metabolic, blood, and immune disorders; and HIV/AIDS were the most overfunded categories relative to DALYs and hospital days. Conditions identified as most underfunded differed depending on use of DALYs or hospital days in estimating predicted funding levels. Conclusions and Relevance NIH funding for pediatric research was correlated with pediatric disease burden in the US with variable correlation based on the disease metric applied. There was substantial overfunding and underfunding of certain conditions. Ongoing evaluation of pediatric funding patterns using a complementary set of disease measures may help inform and prioritize pediatric research funding.

中文翻译：

---

美国国立卫生研究院儿科研究资助与儿科疾病负担之间的相关性。

重要性 美国国立卫生研究院 (NIH) 是全球生物医学研究的最大政府资金来源。疾病负担是 NIH 在分配资金时考虑的因素之一，尽管尚不清楚资金模式与儿科疾病负担的关系。目的 确定 NIH 资助与儿科疾病负担之间的相关性。设计、设置和参与者这项横断面研究评估了 2015 年至 2018 年 NIH 资助的美国儿科研究。儿科补助金根据所研究的疾病类别进行分类。使用健康指标和评估研究所的措施以及 2016 年儿童住院患者数据库的住院数据来确定每个类别的疾病负担。主要结果和衡量 NIH 资助与儿科疾病负担之间的相关性，使用 Spearman 排序系数和基于线性回归模型估计的疾病负担预测的疾病特定资助量。结果 本研究分析了 2015 年至 2018 年美国国立卫生研究院 (NIH) 授予的 14060 项针对特定疾病的儿科拨款。疾病类别的年度资金从 0 美元到 382 849 631 美元不等。儿科研究的资金与儿科残疾调整生命年 (DALY)、死亡、残疾生活年数和生命损失年数相关（r，0.56-0.63；所有测量的 P < 0.001）。资金与基于医院的指标之间也存在相关性，包括住院天数、入院人数和住院费用（r，0.67-0.69；所有指标 P < .001）。相对于 DALYs，8 个疾病类别获得的资金比预期水平高出 5 亿多美元，而 5 个疾病类别的资金比预期水平少 5000 万美元以上。根据预测的资金水平，先天性出生缺陷；内分泌、代谢、血液和免疫疾病；与 DALY 和住院天数相比，HIV/AIDS 是资金过剩最多的类别。被确定为资金最不足的情况因估计预测资金水平时使用的 DALY 或住院天数而异。结论和相关性 NIH 对儿科研究的资助与美国的儿科疾病负担相关，其相关性取决于所应用的疾病指标。在某些条件下存在大量资金过剩和资金不足的情况。