Evaluation of hospitalisation for indigenous children with malnutrition living in central Australia.
OBJECTIVE
To evaluate the effectiveness of hospital admissions for indigenous children with malnutrition in a rural/remote Australian centre.


METHODS
Retrospective review of the medical records.


METHODS
Rural secondary hospital.


METHODS
Remote and rural indigenous children aged less than four years managed for malnutrition in Alice Springs Hospital (ASH).


METHODS
The primary outcome measure was weight gain during hospitalisation and posthospitalisation. Secondary outcome measures were yield of investigations, diagnoses made, treatments given, social interventions, readmission rate and nosocomial infection.


RESULTS
Median age of the 55 children was 15.1 months. Median weight change was 1.5 g day(-1)prior to hospitalisation, 36.7 g day(-1)during and 9 g day(-1)two months following hospitalisation (P < 0.05). Investigations performed had high yields (80% of children had a treatable organic contributor to malnutrition). Nosocomial infection occurred in 21 (38%) children. Readmission occurred at an average of 1.9 times per child (range 0-5), 34 (37%) occurred within three months and 48 (52%) within six months.


CONCLUSIONS
In rural Indigenous children with malnutrition, hospitalisation was effective in re-establishing growth and defining organic contributors to malnutrition. However, the high readmission rate and nosocomial infection mandates that alternative models to nutritional rehabilitation, in addition to a broad psychosocial and public health approach to prevention and management of malnutrition, is required.
Russell
Beth J
BJ
Child and Youth Program, Ngaanyatjarra Pitjantjatjara Council, Darwin, Northern Territory.
White
Andrew V
AV
Newbury
Jonathan
J
Hattch
Carmel
C
Thurley
Jennie
J
Chang
Anne B
AB
D015362:Child Nutrition Disorders / Q000150:complications / Q000208:ethnology / Q000628:therapy*; D002669:Child Welfare; D002675:Child, Preschool; D015897:Comorbidity; D003428:Cross Infection / Q000208:ethnology / Q000209:etiology; D006302:Health Services Research; D006780:Hospitals, Rural; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008485:Medical Audit; D020380:Needs Assessment; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000592:standards*; D010359:Patient Readmission / Q000706:statistics & numerical data; D011634:Public Health; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D015430:Weight Gain