Analysis of the Volume and Quality of Hospital Care to Children With Asthma

BACKGROUND. Asthma is one of the most common chronic conditions in the developed countries and is often cited as the most frequent reason for avoidable hospitalization among children. OBJECTIVES. To evaluate the status and quality of paediatric hospitalisation due to asthma and factors connected with primary care delivery to inpatients. METHODS. An expert evaluation of medical care received by children (aged 2-17 years), hospitalized for asthma to city children’s hospital in connection with the ways of inpatients’ referral at primary level. Information was obtained from Medical inpatient of children discharged with the diagnose of asthma from the hospital. RESULTS. Among the hospitalised persons, whose case records were evaluated, prevailed boys (64.6%). Mean age of patients was 9.1 years, LOS –10.8 days. In 45.8% of episodes children were referred to the hospital by primary level physicians (PLP) (family physicians and district paediatricians – 41.7% and polyclinic allergists – 4.2%) and in 35.5% − allergists of consulting outpatient department of the city children’s hospital. In 10.4% of children were hospitalized at the request of their parents, and 8.3% were delivered by ambulance. More than half of the children (60.4%) at admission had a fourth grade, 27.1% - the third, and 12.5% - second grade of severity of the disease. Allergists of the children hospital had significantly (p medical condition of the child upon admission. Compliance with asthma protocol of the hospital care was in 61.8% cases. In 38.2% of cases protocol requirements have been met partly mainly due to inability to conduct spirometry The proportion of asthma hospitalizations assessed as preventable was 29.3%. CONCLUSIONS. Hospital resources were used inefficiently. The study showed lack of continuity in the work of primary and hospital level in the treatment of children suffering from asthma. In order to raise the quality of hospital care and increase the compliance with MOH of Ukraine asthma protocol of the hospital care the provision of hospital medical equipment should be improved and cooperation and continuity of medical care between primary level and hospital should be established. Keywords: Avoidable (preventable) hospitalisation, asthma, hospital care, children. Normal 0 21 false false false RO X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Times New Roman; mso-bidi-theme-font:minor-bidi; mso-fareast-language:EN-US;}