Causes of Hospitalization among Children Ages Zero to Nine Years Old in the City of São Paulo, Brazil

Abstract

INTRODUCTION:The profile of child morbidity is an important parameter for defining and altering health policies. Studies about infant mortality are more numerous than those on morbidity, especially related to hospital admissions. The objective of this study is to describe the causes of admission in the public health system for children from zero to nine years of age in the city of São Paulo during the years 2002 to 2006 and compare these results to those from the national data.METHOD:Through a cross-sectional study, data were obtained from the Hospital Information System, which is available in the Information System of the Unified Health System - DATASUS.RESULTS:Within the period, 16% of the total admissions corresponded to children from zero to nine years of age, with most of the children being younger than one year of age. In the city of São Paulo, the admission coefficient increased 11%, and in Brazil, it decreased 14%. Respiratory diseases were the main causes of hospitalization. In São Paulo, the second most frequent causes of admission were diseases that originated during the perinatal period (15.9%), and in Brazil, the second most frequent cause of admission was infectious-parasitic diseases (21.7%). Admissions for perinatal diseases increased 32% in São Paulo and 6% in Brazil. While hospitalizations for diarrhea decreased in Brazil, an increase was recorded in the city of São Paulo for children under five years old.CONCLUSIONS:The findings of this study show a paradoxical increase in the number of hospitalizations during an expansion of primary attention, indicating that the rise was not associated with a significant improvement in the quality of service.

Características e fatores associados à hospitalização nos primeiros anos de vida: coorte de nascimentos de Pelotas de 2004, Rio Grande do Sul, Brasil

“…Other Brazilian studies 5,6,11,17 on hospitalization of children found lower hospitalization rates than in the current study. Castro et al 17 , using data from the PNAD 1998, showed an 11.1% hospitalization rate in children under one year and 6.9% from one to four years.…”

“…In PNAD 2008 6 , the hospitalization rate in children under four years of age was 8.4%. Ferrer et al 5 studied hospitalization of children from birth to nine years of age, from 2002 to 2006, in Brazil and in the city of São Paulo, and used data from the Brazilian Hospital Information System of the Brazilian Unified National Health System (SIH-SUS), showing a hospitalization rate of 17% in Brazil and 16% in São Paulo 5 . The National Demographic and Health Survey (PNDS 2006) 11 assessed the morbidity and mortality profile in children less than five years of age in Brazil.…”

“…Worldwide, hospitalizations account for nearly half of public spending in health 2 . Costs are related to the characteristics of the diseases that caused the hospitalization and the patient's age 2,3,4,5 . Diseases with high incidence can lead to the hospitalization of a high number of individuals, which entails higher costs 2,3,4 .…”

“…Hospitalization is a frequent event in early childhood and preschool age 5 . In Brazil, the National Household Sample Survey (PNAD 2008) showed an 8.9% hospitalization rate among children from zero to four years of age.…”

“…In Brazil, respiratory diseases are the leading cause of hospitalization in children under five years, followed by infectious intestinal diseases 5,10 . Hospitalizations from these causes are distributed unequally across the regions of Brazil.…”