Pediatric hospitalizations for ambulatory sensitive conditions in Portugal

Introduction: Hospitalizations can reveal consequences on child development, potentiate infections, and increase hospital costs. About 30% of pediatric hospitalizations can be avoided with adequate outpatient care. Ambulatory care sensitive conditions allow for analyzing these hospitalizations and monitor morbidity, access, and quality of care. The aim of this study was to characterize the hospitalizations in Portugal due to conditions sensitive to a pediatric outpatient clinic. Methods: Hospitalizations were characterized using two methodologies, with episodes of children under 18 years old in 2017 from the Administração Central do Sistema de Saúde database and the patient classification system by a diagnostically related group. A descriptive analysis was performed of the variables gender, age, region, length of stay, and main diagnosis and determined the prevalence, rate of hospitalization, and financial impact. Results: Ambulatory care sensitive conditions represent 13.1% and 17.5% of all pediatric hospitalizations, with the two methodologies applied, with a delay of four days, male prevalence (52%), up to at the age of 4 (> 30%), in the Northern region (> 30%) and the highest rate in the Lisbon region (> 30 hospitalizations/10,000 inhabitants). The main causes are gastroenteritis, urinary tract infection, ear, nose and throat infections, asthma, seizures, and epilepsy. The financial impact is over four million euros. Discussion: The results reveal a potential difference in care needs by region and an indispensable adequacy of the supply and distribution of health resources.