Patterns of disease among children: a simple and versatile measure of child health in communities.
OBJECTIVE
To derive an indicator of community child health that is simple, stable, cost-effective and suitable for small communities.


METHODS
Discharge diagnoses of children have been tabulated for hospitals in Australia and other countries and from an Aboriginal community, for up to 40 years. The differences in ratios between main diagnostic groups relate to the child health status in the community.


RESULTS
As we pass from 'developing' to 'developed' conditions, the proportion of different diagnoses changes with a relative decrease in gastroenteritis and a relative increase in respiratory and other diseases. These changes parallel changes in infant mortality rates and child growth that are independent indicators of community child health.


CONCLUSIONS
The ratios of diagnoses of hospital discharges, the 'disease pyramid' is a reliable, valid and cost-effective way of measuring child health in a community while avoiding many of the uncertainties of conventional disease-specific and age-specific discharge rate statistics.
Dugdale
A E
AE
Department of Child Health, University of Queensland, St Lucia, Australia.
D000059:Accidents / Q000706:statistics & numerical data; D002675:Child, Preschool; D019049:Developed Countries / Q000706:statistics & numerical data; D003906:Developing Countries / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D011041:Poisoning / Q000453:epidemiology; D011793:Queensland / Q000453:epidemiology; D012140:Respiratory Tract Diseases / Q000453:epidemiology; D015030:Zimbabwe / Q000453:epidemiology