Pediatric hospitalizations at two different setting community hospitals in north India: implications for regionalization of care.
OBJECTIVE
To evaluate pediatric hospitalizations at two different setting community hospitals in north India, and to understand the implications for regionalization of pediatric care in heterogeneous environment of India.


METHODS
Retrospective review of medical records of children hospitalized at a large and a small community hospital catering to population from different social classes but in close proximity to each other was carried out. Baseline characteristics and diagnosis were recorded, and compared using appropriate statistical tests.


RESULTS
There were notable differences between the age and morbidity profiles at the two study hospitals. Smaller community hospital catered to more young, malnourished and sicker children. Morbidity profile comprised of significantly more acute gastroenteritis and community-acquired pneumonia at the small hospital. In contrast, almost a quarter (24.4%) of children was injured at the larger community hospital. Infants and newborns were more at small, while older children (>5 yrs) were more at the larger community hospital (p<0.0001).


CONCLUSIONS
The conclusion drawn from this study is that significant differences exist in age and morbidity profiles between different setting community hospitals in north India. There is a need to form a prospective registry of community hospitals, which would validate the observations of the present study, and has implications for regionalization of specialized pediatric services as well as postgraduate training in India.
Garg
Pankaj
P
Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, Qutab Institutional Area, New Delhi, India. pankajparul8@rediffmail.com
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D019538:Health Care Surveys; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data*; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009017:Morbidity; D011336:Probability; D011787:Quality of Health Care; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors