title: [Risk factors for hospitalization of children aged 1 to 4 years in Sao Luis, Maranhao, Brazil].
abstract: Risk factors for pediatric hospitalization were studied using a cross-sectional multi-stage cluster sample survey. A standardized questionnaire was answered by children's mothers or other care providers. In the municipality of São Luís, Maranhão, Brazil, 596 children aged 1 to 4 years were sampled in 50 census tracts. Design effect was calculated for each estimate. Hospitalization rate was 24. 4%. Main causes of hospitalization were pneumonia (7.3%) and diarrhea (7.1%). The Unified National Health System (SUS) and private insurance accounted for 78.1% and 18.2% of hospital admissions, respectively. After adjustment for confounding by Cox proportional hazards model modified for cross-sectional design, children whose families earned less than one minimum monthly wage and those with private insurance were at higher risk of hospitalization. Hospitalization due to outpatient-sensitive diseases accounted for most cases. The U-shaped hospitalization pattern suggests low quality of outpatient services among the poor and may be a proxy indicator for unnecessary and iatrogenic hospitalization among privately insured children.
authors.affiliation: Departamento de Saúde Pública, Universidade Federal do Maranhão, Rua Barão de Itapary 155, São Luís, MA 65020-070, Brasil. aasilva@elo.com.br.
authors.forename: A A
authors.initials: AA
authors.lastname: Silva
authors.forename: U A
authors.initials: UA
authors.lastname: Gomes
authors.forename: S R
authors.initials: SR
authors.lastname: Tonial
authors.forename: R A
authors.initials: RA
authors.lastname: Silva
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D016001:Confidence Intervals; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D015981:Epidemiologic Factors; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D012307:Risk Factors; D012959:Socioeconomic Factors