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PubMed2002

Recommendations for nursing requirements at a field hospital, based on the Israel Defense Forces field hospital at the earthquake disaster in Turkey--August 1999.

On the 17th of August 1999, an earthquake of 7.4 magnitude on the Richter Scale struck the Marmara region in Turkey causing a massive casualties event with an estimated 2,680 deaths and 5,300 injuries just at the city of Adapazari alone. A field hospital was set up by the Israel Defense Forces at Adapazari in order to provide temporary medical services until regular medical forces recovered. The aim of the paper is to overview the requirements of the nursing staff at a field hospital based on our experience and analysis of the nursing activity at the field hospital at Adapazari. The methods implemented include interviewing all nurses and many of the doctors who took part in the field hospital as well as a review of medical literature about disasters. We found an inverted nurse:phycisian ratio of 1:1.77, as opposed to a 2.5-3:1 ratio in regular civilian hospitals. The nurses in our field hospital had to work longer and more intensive shifts than in a regular hospital. They had to overcome language barriers and cultural differences, and faced difficult hygiene conditions. Our overview analysis of results brought up several recommendations. Firstly, although it is not possible to predictthe number and types of casualties, it is necessary to provide an adequate number of nurses (1-1.5:1 nurse:physician ratio). Furthermore, the nurses should be specialized and rotated as needed. Secondly, the language and cultural barriers should not be undermined despite the abundance of translators. Finally, the hygiene status in a field hospital requires management by nurses with active participation of all members.

Communication Barriers↗
PubMed2002

Are high-volume surgeons and hospitals the most important predictors of in-hospital outcome for colon cancer resection?

BACKGROUND: Although recent studies have reported that high-volume surgeons and hospitals have better outcomes for colon cancer resections, it remains unclear whether there are other factors that are more important than volume. This study aims to evaluate the importance of the volume variables relative to other factors in an attempt to target specific areas for improving outcomes. METHODS: Using nationwide data from the Healthcare Cost and Utilization Program, full-model logistic regression was performed on all patients undergoing colon cancer resection. In hospital mortality was regressed against more than 30 different independent variables, including demographic factors (eg, age, gender, race, ethnicity, and socioeconomic status), burden of morbid and comorbid disease (prevalence and severity), and provider variables (eg, hospital size, location, teaching status, hospital and surgeon volume). A separate baseline probability analysis was then performed to compare the relative importance for all predictor variables. RESULTS: The sample size for this analysis was 22,408; 622 in-hospital deaths occurred (2.8%). Average age was 70 years old, 51% of particIpants were male, and 60% had at least 1 comorbid disease. An operation was elective (64%), urgent (19%), or emergency (15%). The significant predictors for mortality (at P <.05) included age, gender, comorbid disease (ie, cardiovascular, pulmonary, liver), operation severity (ie, emergency, urgent), and volume (both hospital and surgeon). The baseline probability analysis shows that the mortality for a baseline case is 12/1000. If this baseline case goes to a high-volume hospital or surgeon, the mortality will decrease to 11/1000 and 10/1000, respectively. If a patient with a baseline case of colon cancer also has coexistent liver disease or requires an emergency operation, mortality increases to 44/1000 and 45/1000, respectively. Overall, the volume variables, although statistically significant, have a relatively smaller effect on outcome compared with other factors. CONCLUSIONS: Whereas other factors have a stronger association with outcome than volume, volume is the only acutely mutable variable. Although the regionalization controversy (ie, using only high-volume surgeons or hospitals) is not solved with our findings, this study elucidates and compares the relative importance of several different factors on outcome, which is essential when considering the conclusions and implications of this type of policy-relevant outcomes research.

Aged↗
PubMed2003

Prevalence of prenatal drinking assessed at an urban public hospital and a suburban private hospital.

BACKGROUND: Although the prevalence of fetal alcohol syndrome (FAS) varies within the population, few data are available concerning variation in the prevalence of prenatal drinking. METHODS: Postpartum women delivering singleton infants at two Atlanta hospitals in 1993 or 1994 were interviewed. Those delivering infants who were small for gestational age (SGA) (n = 638) were over-sampled relative to those delivering infants with birth weights that were appropriate for gestational age (AGA) (n = 247). The prevalence of prenatal drinking was estimated as a weighted average of reports from mothers of SGA and AGA infants. Estimates of the prevalence of FAS come from the Metropolitan Atlanta Congenital Defects Program (MACDP) of the Centers for Disease Control and Prevention. RESULTS: The prevalence of first-trimester drinking was half that reported for the three previous months (private hospital: 72% vs. 35%; public hospital: 52% vs. 28%). Most women (85%) reported abstaining throughout the second trimester. Fewer than 10% of women delivering at the public hospital (7.5%), but one-quarter of those delivering at the private hospital, reported third-trimester drinking. Binge, moderate and heavy drinking in pregnancy were more common among women delivering at the public hospital. Eight infants born at the public hospital during this period, but none of those born at the private hospital, were identified as possibly having FAS; four of the eight were identified as probably having FAS. CONCLUSIONS: These results have implications for health education programs. For example, obstetricians in private practice may wish to reaffirm their advice to abstain from drinking in the third trimester. They also suggest that prenatal abstinence programs be targeted at populations identified as most likely to engage in risky drinking.

Alcohol Drinking↗
PubMed2002

The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost.

OBJECTIVE: To measure the impact of orthopedic surgical-site infections (SSIs) on quality of life, length of hospitalization, and cost. DESIGN: A pairwise-matched (1:1) case-control study within a cohort. SETTING: A tertiary-care university medical center and a community hospital. PATIENTS: Cases of orthopedic SSIs were prospectively identified by infection control professionals. Matched controls were selected from the entire cohort of patients undergoing orthopedic surgery who did not have an SSI. Matching variables included type of surgical procedure, National Nosocomial Infections Surveillance risk index, age, date of surgery, and surgeon. MAIN OUTCOME MEASURES: Quality of life, duration of postoperative hospital stay, frequency of hospital readmission, overall direct medical costs, and mortality rate. RESULTS: Fifty-nine SSIs were identified. Each orthopedic SSI accounted for a median of 1 extra day of stay during the initial hospitalization (P = .001) and a median of 14 extra days of hospitalization during the follow-up period (P = .0001). Patients with SSI required more rehospitalizations (median, 2 vs 1; P = .0001) and more total surgical procedures (median, 2 vs 1; P = .0001). The median total direct cost of hospitalizations per infected patient was $24,344, compared with $6,636 per uninfected patient (P = .0001). Mortality rates were similar for cases and controls. Quality of life was adversely affected for patients with SSI. The largest decrements in scores on the Medical Outcome Study Short Form 36 questionnaire were seen in the physical functioning and role-physical domains. CONCLUSIONS: Orthopedic SSIs prolong total hospital stays by a median of 2 weeks per patient, approximately double rehospitalization rates, and increase healthcare costs by more than 300%. Moreover, patients with orthopedic SSIs have substantially greater physical limitations and significant reductions in their health-related quality of life.

Cross Infection↗
PubMed2002

Hospital in the home is cost saving for appropriately selected patients: a comparison with in-hospital care.

BACKGROUND: As the cost of acute care in hospitals increases, there is an increasing need to find alternative means of providing acute care. Hospital in the home (HITH) has developed in response to this challenge. Current evidence is conflicting as to whether HITH provides cost savings compared with in-hospital care (IHC). The heterogeneous nature of HITH and the clinical complexity of patients is the greatest obstacle to making valid comparisons between the two modes of care. OBJECTIVE: To compare costs and outcomes of HITH to IHC in hospitals in Victoria, Australia. DATA SOURCES/STUDY SETTING: Hospital morbidity data and medical records from Victoria, Australia. STUDY DESIGN: A costing study of 924 randomly selected episodes of HITH care, individually matched to 924 comparable IHC episodes. METHODS: Unadjusted total episode costs (TEC) and averaged daily costs for HITH and IHC were calculated. Mortality and length of stay (LOS) were compared for HITH and IHC episodes. Simple linear and multiple regression were used to analyse costing data, while logistic regression was used to compare in-hospital mortality and LOS in HITH versus IHC episodes. PRINCIPAL FINDINGS: The 1848 episodes of care in the sample represented a heterogeneous range of acute conditions in 31 Victoria hospitals. HITH consisted of two distinct subgroups: pure-HITH (total episode substitution) and mixed-HITH (partial episode substitution). The cost of episodes of acute care containing a HITH component were overall 9% less expensive than IHC (P = 0.04), while pure-HITH was 38% cheaper than matched IHC (P < 0.001). The variable HITH, along with LOS and chemotherapy, explained the 60% variation in TEC. The mean cost of pure-HITH episodes was 22% lower compared to mixed-HITH (P = 0.004). The in-hospital mortality rate in HITH (3.8%) and IHC (5.2%) was not significantly different. Pure-HITH was associated with shorter LOS, while mixed HITH was strongly associated with longer LOS. CONCLUSION: In our study the adjusted cost of HITH was significantly cheaper than IHC, particularly as total episode substitution. The cost needs to be adjusted because many factors other than HITH or IHC can influence crude costs. There may be potential for wider use of HITH for appropriately selected patients.

Acute Disease↗
PubMed1996

Appropriateness of admission and the last 24 hours of hospital care in medical wards in an east London teaching group hospital.

OBJECTIVE: To assess the rates of inappropriateness of admission and last day of care on adult medical wards in an east London hospital, to identify associations with any inappropriateness and to assess what services need to be improved or provided if patients assessed as "inappropriate" are to be more appropriately placed in the future. DESIGN: From the patients' medical notes, nursing notes and ward charts, a trained reviewer with nursing and university qualifications collected concurrent information about each patient's first 24 hours as an in-patient and about the last 24 hours of care preceding discharge. Patients were also interviewed before discharge and 7-10 days after discharge, and their health status and level of satisfaction about the discharge process assessed. SETTING: The three adult medical wards at the Homerton Hospital in Hackney, east London. This hospital is within the St Bartholomew's Hospital Teaching Hospital Group. SUBJECTS: The case-notes of a random sample of 625 adult in-patients were reviewed. END POINTS: Appropriateness of admission and last day of care. MAIN OUTCOME MEASURES: The main instrument used was the Appropriateness Evaluation Protocol (AEP). This is an instrument devised to assess the appropriateness of adult patient admission to, and specific days of care in, acute hospital beds through case-note review against a structured set of criteria. RESULTS: The study presented here reported that 31% of in-patient admissions to adult medical wards in an east London hospital were inappropriate, and also that 66% of the last days of stay were inappropriate. CONCLUSIONS: There is clearly considerable room for improvement in relation to cooperation between service providers in order to maximise efficient bed use. Delays due to waiting for medications from pharmacy, and the combination of more "inappropriate" cases wanting help from social services after discharge with the fact that many of them were still in hospital because they were waiting for these services to be organized, suggest that inappropriateness could be reduced through increased efficiency or increased provision in these areas. The study reported here is unique in its inclusion of patient interview data.

Adult↗
PubMed2003

Patient satisfaction with and recommendation of a hospital: effects of interpersonal and technical aspects of hospital care.

OBJECTIVES: To examine patient satisfaction with and recommendation of a hospital, with a special focus on the correlation of these measures to patient ratings of interpersonal and technical performance of the hospital. DESIGN: Telephone survey of patients with four specific conditions after their discharge from hospitals. SETTING: Accredited district teaching hospitals and above, nationwide in Taiwan. PARTICIPANTS: A total of 4945 patients from 126 hospitals diagnosed with or undergoing procedures related to stroke, diabetes mellitus, Caesarean section, or appendectomy were interviewed by telephone. MAIN OUTCOME MEASURES: Overall patient satisfaction and recommendation were measured by single-item questions. Interpersonal skills were measured by three items: doctors' explanation, attitude, and caring. Technical skills were measured by another three items: hospital equipment, clinical competence, and outcome of treatment. RESULTS: Interpersonal skills were as influential or more influential than clinical competence on patient satisfaction for three of the four disease categories. In contrast, technical competence was a more influential predictor for recommendation for patients in all four disease categories. CONCLUSION: The preliminary results imply that a hospital with high percentage of patient satisfaction does not necessarily receive a high level of recommendation. This finding provides new insights for researchers and for hospital managers who devote resources exclusively for achieving the highest possible levels of patient satisfaction.

Adolescent↗
PubMed2005

Impact of enforcing the Labour Ordinance, with 1-in-7-day off for hospital doctors, on weekend hospital discharge rate.

BACKGROUND: After enforcing the Labour Ordinance, hospital doctors must have 1 day off-work every week. In this study, we aimed to evaluate its impact on the discharge pattern from an acute medical hospital. METHODS: We undertook a hospital-based ecologic study with before-after design using the clinical management database of patient discharge records of all acute medical wards in a hospital from January to March 2002 (1 year before new system) and from January to March 2004 (1 year after restricted weekend service). The main outcome measures were the daily discharge rates for the two periods. The odds of being discharged on a Saturday were estimated by multivariate analyses. RESULTS: The number of patient discharge on a Saturday was substantially lower in 2004 as compared to 2002 (47.5 +/- 8.5 per Saturday versus 70.5 +/- 11.1 per Saturday, respectively, p < 0.001). A statistically significant decreased trend was noted in the weekend discharge rate in 2002 and 2004 (Poisson p-value for change in discharge rate, p < 0.001). On the other hand, the number of patient discharges on weekdays did not differ between the two periods. Consistently fewer patients were being discharged on Sundays and Mondays as compared to the rest of the week days in both periods. Compared with study period 2002, patients hospitalized in 2004 (with limited weekend service) had significantly lower multivariate-adjusted odds of being discharged on a Saturday (odds ratio of 0.70; 95 percent confidence interval 0.72-0.89, p < 0.0001). CONCLUSIONS: Length of hospital stay is influenced by the health care system delivery apart from clinical factors. Restricted weekend services in an acute medical hospital setting substantially lengthen the hospital stay, and might therefore entail a major financial burden.

Aged↗
PubMed1979

Multiple hospital systems and the teaching hospital.

A substantial portion of hospital beds are in institutions that are in multiple hospital systems having varying degrees of formal linkage. Relatively few core teaching hospitals are part of such systems, but they do share strong relationships with their parent medical schools and affiliated hospitals. The missions of core teaching hospitals are patient care, education, and research. The traditional affiliation arrangement between hospitals permits the parent university to achieve these missions. The possible benefits to be gained through participation in a multiple hospital system do not appear to be of sufficient magnitude to either core teaching hospitals or their parent universities to persuade them to join or form such a system.

Economics, Hospital↗
PubMed2004

[Hospital mortality and length of stay: comparison between public and private hospitals in Ribeirão Preto, São Paulo State, Brazil].

Performance assessment in health services is essential. The comparison of performance indicators requires the use of risk adjustment strategies. The objective of this paper was to assess variations in clinical performance, measured by hospital mortality and length of stay, between private and public hospitals, while taking into account the hospital case mix. This study is located in the Ribeirão Preto region in São Paulo State, Brazil. From 1996 to 1998, 32,906 patients admitted with cardiovascular and respiratory diagnoses were studied. Variables used for risk adjustment of performance indicators were: sex, age, principal diagnosis, and severity measures based on co-morbidity. Clinical performance in public hospitals as measured by adjusted hospital mortality (OR = 0.41) was better than in private hospitals. Public and private hospitals were not statistically different concerning patients' length of stay. Although some conceptual and methodological problems persist, hospital mortality and other adjusted performance indicators should be considered as useful tools to identify health services' performance problems.

Adolescent↗
PubMed2006

Strategic human resource management issues in hospitals: a study of a university and a community hospital.

The human factor is central to healthcare, yet its proper management has remained beyond the reach of healthcare organizations. This qualitative study examines strategic human resource management (HRM) issues in a university and a community hospital. The findings indicate that the two hospitals lacked a clear understanding of their strategic intent and objectives; as a result, their human resource (HR) practices lacked coherence and direction. Whereas the community hospital understood the interrelationship between culture and HRM, the university hospital did not. Moreover, the university hospital showed only a modest understanding of competencies needed in managing HR function, which hampered its ability to identify competent HR managers and employees. The community hospital made significant gains in the past few years in managing its culture and people by recruiting a competent HR manager. The relationship between HR practices and clinical outcomes was much less clear in the university hospital than it was in the community hospital.

Hospitals, Community↗
PubMed1990

[Comparative study on head nurses' perception to own role and staff nurses' role expectation to their head nurse between university hospitals and general hospitals].

The organization of nursing department significantly effects the hospital management. Especially, the head nurse is one of the most important position because head nurse is a first-line manager in the hospital level, a middle manager in nursing service organizations level and the top manager in each nursing unit level. This study was attempted to show the ideal model and rule by compare head nurses' role perception with staff nurses' role expectation according to two types of hospital. The survey was conducted among 94 head nurses and 233 staff nurses who are working at 5 different University Hospitals over 600 beds and 93 head nurses and 218 staff nurses who are working at 12 different General Hospitals between 100-300 beds in Seoul. The data was collected in a period from 8th September to 13th October in 1989 and the instrument used for this study was based on Han's one and referred back to many literary sources and revised. The collected data was analysed by computer using S.P.S.S. program as a Mean, Percentage, Cronbach's alpha, Chi-Square, t-test and ANOVA. 1. The study was compared to the difference of the two subject group's general characteristics according to a type of hospital. As a result, there were significant differences in age, educational background and career. 2. This Study was compared to the difference of the two subject group's role perception and role expectation about each question according to a type of hospital. The result of this comparisons as follows: First, These were the most important issue between both groups: "Head nurse has to know about her staff's events and problems and then help them to solve that promptly" Second, These were the least important issue between both groups: "Head nurse has an interview with patient's family and visitors", "Head nurse is interested in her staff's privacy". 3. This study was compared to the differences of each role areas according to a type of hospital. As a result, there were no significant differences both two subject groups except nursing manager role in staff nurses' group (t = -2.893, df = 449.0, p = 0.004). 4. This study was tested to the difference of the two subject groups according to general characteristics. As a result, All of that there were no significant differences.

Hospitals, General↗
PubMedDate not supplied

[Social class, mode of admission, severity of illness and hospital mortality: an analysis with "All patient refined DRG" of discharges from the Molinette hospital in Turin].

Data available from the standard hospital discharge database (SDO) allow us to explore differences in health conditions according to different indicators of socioeconomic status (SES). We analysed all the patients aged 30-59, discharged from the S. Giovanni Battista (Molinette) hospital (the main general hospital in Turin, Italy) during three years (1996-1998) (n = 49949). Three health indicators were used as outcomes: a) emergency admission; b) severity of illness (according to the "All Patient Refined DRGs" subclasses); c) hospital mortality. Patients were compared for each outcome according to two different SES indicators: a) level of education; b) employment status. Logistic regression models (both conditional and unconditional) were used to adjust for several potential confounders. Patients with lower education (up to 5 years of schooling), compared to those with 13 or more years of schooling, showed a higher probability of being admitted through the emergency ward (29.1% vs 23.3%), with an odds ratio (OR) = 1.56-95% confidence interval (95% CI) = 1.45-1.68; of being classified in higher severity subclasses of illness (23.3% vs 17.7%, OR = 1.14; 95% CI = 1.07-1.22) and of dying in hospital (2.3% vs 1.6%). However, after adjustment for other prognostic factors (as severity of illness and specific expected mortality), this association disappeared (OR = 1.05, 95% CI = 0.84-1.32). Similar, but somewhat stronger, associations were observed when comparing the unemployed versus the employed. The corresponding figures (ORs; 95% CI) were 1.57 (1.42-1.74) for emergency admission; 1.31 (1.18-1.45) for severity of illness and 1.55 (1.10-2.16) for hospital mortality. In conclusion, this study showed that SES differentials in health are clearly measurable through routine hospital information systems, and documented that patients of low SES, particularly unemployed, experienced a delayed access to hospital, were admitted in poorer general health conditions and had a more unfavourable prognosis.

Catchment Area, Health↗
PubMed2004

Length of hospital stay, diagnoses and pattern of investigation following emergency admission to an Irish teaching hospital.

Data on discharges from acute public hospitals in Ireland is recorded in the hospital in-patient enquiry (HIPE) system; its value in describing the casemix and pattern of resource utilization following emergency medical admissions has not been examined. We wished to determine whether there was a relationship between coded diseases at the time of discharge, patterns of investigation, and length of hospital stay (LOS) in a major teaching hospital. Data relating to emergency medical patients admitted to St James' Hospital Dublin between 1st January and 31st December 2002 was recorded. Of 5038 episodes evaluated, the median LOS was 6 days (IQR 3-13); this was significantly shorter when the patient was admitted under a general medical service (p<0.0001). There was also a positive correlation between patient age and LOS (r = 0.32; p<0.0001). No test request was associated with a shortened LOS. Prolonged LOS was associated with oesophago-gastro-duodenoscopy, echocardiography, computerised tomography, magnetic resonance imaging, and abdominal ultrasonography testing. Furthermore, prolonged LOS was associated with the following disease related groups (DRG) at discharge; codes related to heart failure, respiratory system, malignancy, stroke, diabetes, psychiatry, and anaemia. We found that clinical coding using the HIPE database strongly predicted hospital LOS for acute general medical admissions. Spare bed capacity is essential if an acute hospital is to operate efficiently and at a level of risk acceptable to patients. Therefore, determining major influences on hospital LOS is valuable, to develop potential strategies to optimise efficient utilization of acute bed capacity.

Adult↗
PubMed2006

Community hospital versus tertiary hospital comparison in the treatment and outcome of patients with acute coronary syndrome: a New Zealand experience.

AIMS: To compare the baseline characteristics, use of evidence-based medications, rate of revascularisation, and mortality of acute coronary syndrome (ACS) patients managed in a community hospital (Invercargill Hospital) without, and a tertiary teaching hospital (Dunedin Hospital) with, catheterisation and an interventional facility. METHODS: All patients with ACS admitted into Dunedin and Invercargill coronary care units (CCUs) between 2000-2002 inclusive were included in the study. RESULTS: Major baseline characteristics including age, history of diabetes, heart rate and systolic blood pressure at presentation were not different between the two centres. However, the proportions of patients with ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI) were higher in Invercargill CCU. More Invercargill patients experienced a cardiac arrest or clinical heart failure on hospital arrival. The use of evidence-based medications, coronary angiography (65.5% vs 20.2%, p<0.00001), and revascularisation (46.7% vs 16.4%, p<0.0005) were significantly higher in patients admitted into Dunedin CCU. The in-hospital, 6-months, and 1-year mortality was significantly lower (absolute mortality difference of 4.3%, 9.5%, and 10.0%, p<0.05, respectively) for ACS patients admitted into Dunedin CCU. Using multivariable logistic regression incorporating baseline characteristics, use of evidence-based medicine on arrival and transfer for angiography, the 1-year adjusted hazard ratio 3.02 (95%CI 1.60-5.71) remains significantly higher for patients in Invercargill Hospital. CONCLUSION: There was a disparity in ACS outcome between community and tertiary hospitals in New Zealand. The use of evidence-based medicine in all ACS patients should be encouraged even if revascularisation was not offered.

Acute Disease↗
PubMed1990

[From hospice to high-rise hospital--the development of western hospitals].

Departing from the first infirmaries in the Roman army installed as valetudinaria exclusively for sick and wounded soldiers the development of western hospital care began based on the idea of love for fellowman. The importance of the order of Monte Cassino founded by Benedict of Nursia in the 6th century is emphasized. The role of these hospices important as asylums and hospitals with spiritual assistance is exposed as well as the endeavours of lords, kings and citizens to found hospitals in the modern sense from the 17th century onwards. The institution of the general hospital became important from 1784 onwards in Vienna and soon thereafter in Berlin. Modern nursing movements developed from protestant nursing sisters in Kaiserswerth. Further organizations for nursing such as those initiated by Florence Nightingale and Agnes Karll and the establishment of organizations such as the Red Cross are discussed. During the 19th century the large hospitals were built, modeled either after the compact system of barracks or conceived to prevent hospitalism as pavilions. Specialized institutions developed at the same time from older asylums for plague, mentally ill or leprous patients. The most recent development of high rise hospitals as well as the ideas of disposable hospitals serve to discuss functional structures of a modern health care institution.

Europe↗
PubMedDate not supplied

Risk factors for hospitalization and death from diarrhea in a public pediatric hospital in Rio de Janeiro, Brazil.

OBJECTIVE: This study was carried out in a public pediatric hospital located in the city of Rio de Janeiro, Brazil, with the aim of identifying risk factors for hospitalization and/or death due to diarrhea in children. MATERIAL AND METHODS: The study included 406 children under three years of age who were seen or admitted for diarrhea from January 1987 to February 1988. The main variable of interest was the outcome of clinical evaluation and subsequent hospitalization, which was classified as follows: 1) outpatient treatment; 2) hospitalization and survival; and 3) death during hospitalization. The chi-square test was used to identify variables (p = < 0.05) that were significantly related to the treatment outcome. RESULTS: The group was composed by 60.6% males and 39.4% females. A proportion of 26.8% of children was under two months of age, 24.9% was 3-5 months old, 25.9% was 6-11 months old, and 22.4% was 12 months or older. The variables most significantly related to the risk of hospitalization from diarrhea were age, current nutritional status (weight-for-age percentile), and concomitant illness. Variables most significantly associated with risk of death from diarrhea were low birth weight and past hospitalization. CONCLUSIONS: Use of this study's results by health services could make a substantial contribution to reducing children's hospitalization and death due to diarrhea in the city of Rio de Janeiro.

Age Factors↗