title: [What would happen if day care centers closed?].
abstract: OBJECTIVE
  To determine the possible association between the decrease in emergency episodes and the strike in day care centers in Vitoria (Spain) in the autumn of 2004, which affected 86 % of children attending these centers.
  
  
  METHODS
  We performed a retrospective observational study. In Vitoria, there were 27404 children under the age of 14 in 2004; of these, 5890 were under the age of 3 years. The day care centers on strike affected 25.4 % of the latter. We compared emergency episodes and hospital admissions during the strike (September to November, 2004) with those occurring in the previous 5 years. To contrast the hypothesis, a comparison of proportions was used with statistical significance set at p < 0.005.
  
  
  RESULTS
  A significant decrease (rate x 1000 inhabitants) was observed in the number of emergency episodes in children under 3 years old in two of the three months of the strike (October and November, p < 0.01). No significant differences were observed in emergency rates in children aged more than 3 years old, or in hospital admissions in all ages.
  
  
  CONCLUSIONS
  These data suggest that children attending day care centers have a higher risk of catching banal diseases (which do not require hospital admission and are probably infectocontagious illnesses) than children not attending these centers, thus increasing demand for pediatric emergency services. Since the solution does not lie in closing day care centers, hygienic and sanitary measures should be maximized in these centers.
authors.affiliation: Servicio de Pediatría, Hospital Txagorritxu, Vitoria, España.
authors.forename: J
authors.initials: J
authors.lastname: Montiano Jorge
authors.forename: I
authors.initials: I
authors.lastname: Ocio Ocio
authors.forename: I
authors.initials: I
authors.lastname: Díez López
authors.forename: A
authors.initials: A
authors.lastname: Matilla Fernández
authors.forename: A
authors.initials: A
authors.lastname: Bosque Zabala
mesh_terms: D002656:Child Day Care Centers / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D013030:Spain