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Preventable pediatric hospitalizations and access to primary health care in Italy
Rossella Zucco1, Claudia Pileggi1, Martina Vancheri1
1Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy.
Insights
Over 10% of pediatric hospitalizations for ambulatory care-sensitive conditions (ACSC) were preventable. Improving community pediatrician access and district health services can reduce these avoidable admissions.
Area of Science:
- Pediatrics
- Healthcare Management
- Public Health
Background:
- Ambulatory care-sensitive conditions (ACSC) represent a significant burden on healthcare systems.
- Quantifying preventable pediatric hospitalizations is crucial for resource allocation and quality improvement.
Purpose of the Study:
- To quantify the incidence of avoidable pediatric hospital admissions for ACSC.
- To identify demographic and healthcare utilization factors associated with preventable hospitalizations.
Main Methods:
- Retrospective review of pediatric medical records from a 474-bed acute care hospital in Catanzaro, Italy.
- Comparison of 451 admissions for ACSC against randomly selected control cases.
- Analysis of discharge diagnoses and patient characteristics.
Main Results:
- 10.5% (451/4293) of pediatric hospitalizations were deemed preventable.
- Leading diagnoses included dehydration, pneumonia, seizures, and COPD.
- Preventable admissions were more common in females, younger children, and those with less prior community pediatrician or district health service use.
Conclusions:
- A substantial proportion of pediatric hospitalizations for ACSC are preventable.
- Enhanced utilization of community-based pediatricians and district health services may reduce hospital admissions.
- Improved integration between hospital and community health services is needed to mitigate the burden of preventable pediatric hospitalizations.
Abstract:
The aim of this study was to quantify the burden of avoidable pediatric hospital admissions for Ambulatory care-sensitive conditions (ACSC) and to identify factors related to these preventable hospitalizations. The study was conducted by retrospectively reviewing all medical records of children admitted in a non-teaching 474-bed acute care hospital located in Catanzaro (Italy) for an avoidable hospitalization diagnosis. Two control clinical records involving children hospitalized for clinical conditions not classified as ACSC were randomly selected for each clinical record that included an ACSC. Among the 4293 pediatric hospitalizations, 451 (10.5%) were judged to be preventable. Of these, the most frequent discharge diagnoses were: dehydration (29.7%), pneumonia (17.7%), seizures (15.7%) and chronic obstructive pulmonary disease (12.9%).Children admitted for a preventable hospitalization were more likely to be females, to be younger, to be residents in the same province as the hospital and less likely to have had at least one Community-Based Pediatrician (CBP) access in the previous year and to have used the district health service. The burden of pediatric preventable hospitalizations found in this study is quite high, and the results show that there is still work that lies ahead on the way to improve interaction between hospital and community-based services.
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