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[Care of non-severe acute diarrhea in infants: a socioeconomic approach]
1Laboratoire d'Epidémiologie, Economie de la Santé et de Prévention, Toulouse.
Insights
Non-severe acute diarrhea (NSAD) in children often leads to costly hospitalizations, primarily due to vomiting. Improving primary care referrals can reduce hospital stays and healthcare expenses.
Area of Science:
- Pediatrics
- Health Economics
- Public Health
Background:
- Non-severe acute diarrhea (NSAD) in children presents a significant healthcare burden.
- Treatment modalities for NSAD vary, impacting patient outcomes and costs.
- Understanding referral patterns and reasons for hospitalization is crucial for optimizing care.
Purpose of the Study:
- To assess socio-economic status and treatment costs for children with NSAD across different care settings.
- To identify reasons for hospitalization among children with NSAD.
- To propose measures for improving healthcare delivery and reducing hospitalization rates and costs for NSAD.
Main Methods:
- A 3-month study involving 267 children with NSAD treated in general practitioner offices, pediatrician offices, hospital emergency services, or as inpatients.
- Assessment of socio-economic status and treatment costs for all participants.
- Analysis of referral sources and reasons for hospitalization.
Main Results:
- Children admitted to hospitals were often referred by hospital out-patient departments and general practitioners.
- General practitioners, unlike pediatricians, tend to treat more socially disadvantaged patients.
- The primary reason for hospitalization was diarrhea with vomiting (55%).
- Hospital treatment for NSAD is 60 times more expensive than home-based care.
Conclusions:
- Redefining hospital roles and enhancing cooperation with primary care physicians can decrease NSAD hospitalizations and length of stay.
- Implementing proposed measures offers significant economic benefits by reducing high-cost hospital care for NSAD.
- Optimizing referral pathways and primary care management is essential for cost-effective pediatric diarrhea treatment.
Abstract:
During a period of 3 months, 267 children with non severe acute diarrhea (NSAD) were treated by one of four modalities of care: in the private office of a general practitioner (n = 58), or of a paediatrician (n = 109), in a hospital emergency service (n = 62), or as hospital inpatients (n = 38). The socio-economic status and the cost of treatment for each of these children was subsequently assessed. The children admitted to hospital were mainly referred by hospital out-patient departments (47%) and general practitioners (37%) who, unlike paediatricians, care for more socially disadvantaged patients. The main reason for hospitalization was the presence of diarrhea with vomiting (55%). Several measures are proposed to redefine the role of the hospital and to improve cooperation with doctors in office practice, which would reduce both the number of hospitalizations due to NSAD and the length of hospital stay. Since the cost of treating NSAD hospital is 60 time greater than care at home, these measures are economically important.