title: [Children with special health care needs: prevalence in a pediatric hospital and associated risks].
abstract: BACKGROUND
  "Children with special health care needs" (CSHCN) is a novel definition for pediatric patients with chronic diseases, adopted by the Chilean Pediatric Society in 2008. As life expectancy in Chile increases, prevalence of CSHCN is progressively growing, leading to higher health costs.
  
  
  OBJECTIVE
  To describe the epidemiological profile and clinical characteristics of hospitalized CSHCN, and compare the risk assessment of adverse events during hospitalization using two definitions for CSHCN.
  
  
  METHODS
  A cohort of hospitalized CSHCN in a Pediatric Center at Santiago, Chile, was followed from September to December 2009. Clinical and demographic data were registered in a database, including admission to intensive care unit (ICU), nosocomial infections and prolonged hospitalization (> 7 days). Incidence ratios for these events were compared between CSHCN and non-CSHCN, and between children attended by three or more health care professionals (CSHCN-3) and non-CSHCN.
  
  
  RESULTS
  Nine hundred twenty patients were included (54% male), with a median age 14 months (0-221) and median days of hospitalization 4 days (1-229). Prevalence of CSHCN was 60.8% of hospitalized children. When using CSHCN definition and comparing with non-CSHCN, no excess of risk was documented. On the other hand, prevalence of CSHCN-3 was 19.9%. Compared to non-CSHCN, these patients had a higher risk of ICU admission (relative risk (RR) 1.58; 95% confidence intervals (CI) = 1.22-2.05; p < 0.01), nosocomial infections (RR 2.28; 95% CI = 1.54-3.39; p < 0.001) and prolonged hospitalization (RR 1.99; 95% CI = 1.52-2.60; p < 0.001).
  
  
  CONCLUSIONS
  One in five hospitalized children met CSHCN-3 definition. These patients had an increased risk of adverse events during their hospitalization compared to non-CSHCN.
authors.affiliation: Servicio de Salud Metropolitano Sur Oriente, Complejo Asistencial Dr. Sótero del Río, Santiago, Chile. jcflorescano@gmail.com
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Flores
authors.forename: Daniela
authors.initials: D
authors.lastname: Carrillo
authors.forename: Lorena
authors.initials: L
authors.lastname: Karzulovic
authors.forename: Jaime
authors.initials: J
authors.lastname: Cerda
authors.forename: Gabriela
authors.initials: G
authors.lastname: Araya
authors.forename: María Soledad
authors.initials: MS
authors.lastname: Matus
authors.forename: Guillermo
authors.initials: G
authors.lastname: Llévenes
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Menchaca
authors.forename: Nelson A
authors.initials: NA
authors.lastname: Vargas
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002673:Child, Hospitalized / Q000706:statistics & numerical data; D002675:Child, Preschool; D002677:Chile / Q000453:epidemiology; D002908:Chronic Disease / Q000145:classification / Q000453:epidemiology*; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male