title: Frequency of genetic diseases and health coverage of children requiring admission in a general pediatric clinic of northern Greece.
abstract: BACKGROUND
  In order to estimate the causes of pediatric morbidity in our area, with particular emphasis on diseases with a genetic background, we retrospectively categorized the admissions of all children hospitalized in the Department of Pediatrics of the University General Hospital of Alexandroupolis, in the area of Evros, Thrace, Greece over the three year period 2005-2007. Finally, in order to guide health care administrators to improve the delivery of pediatric health care services, we estimated the percentage of hospitalized children who were uninsured and the type of health insurance of those who had medical coverage.
  
  
  METHODS
  The causes of admission, as recorded in the medical records were categorized in terms of the major organ and/or system involved and/or the underlying pathology, with emphasis on diseases with a genetic background. Duplicate admissions, i.e., admissions of the same child for the same underlying disease were excluded. Additional information recorded was age, sex, and type of health insurance of all admitted children. Distribution of the causes of admission by study year was compared by chi-square. A p value < 0.05 was considered significant.
  
  
  RESULTS
  Over the study period, there were 4,947 admissions in 2,818 boys and 2,129 girls. Respiratory diseases were the most common accounting for 30%, while infectious diseases followed with 26.4%. The frequency of chromosomal abnormalities among the hospitalized children was only 0.06%. However, if we consider diseases with an underlying genetic background, this percentage rises to 5%. Approximately 10.3% of the admitted children had no health insurance.
  
  
  CONCLUSIONS
  The percentage of children hospitalized in our area due to a disease with an underlying genetic background was 5%. This percentage pertains to a Department of Pediatrics that has no inpatient subspecialty units and which is located within a General hospital, because hospitalizations for genetic diseases are more frequent in specialized pediatric hospitals, with competence in clinical genetics. The double figure of uninsured children is worrisome and dictates the need for governmental efforts for universal pediatric health coverage in our country.
authors.affiliation: Department of Genetics, Democritus University of Thrace Medical School, Dragana, Alexandroupolis 68100, Greece. lialiari@med.duth.gr
authors.forename: Theodoros
authors.initials: T
authors.lastname: Lialiaris
authors.forename: Elpis
authors.initials: E
authors.lastname: Mantadakis
authors.forename: Dimitra
authors.initials: D
authors.lastname: Kareli
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Mpountoukas
authors.forename: Aggelos
authors.initials: A
authors.lastname: Tsalkidis
authors.forename: Athanassios
authors.initials: A
authors.lastname: Chatzimichail
mesh_terms: D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000191:economics* / Q000592:standards; D005260:Female; D030342:Genetic Diseases, Inborn / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D006115:Greece / Q000453:epidemiology; D017721:Hospital Costs; D006760:Hospitalization / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000191:economics*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000191:economics*; D008297:Male; D012189:Retrospective Studies