Evitable pediatric mortality
A contribution to planning health care for children
Keywords:
CHILD'S HEALTH, CHILD MORTALITY, PREVENTIVE HEALTH SERVICES, DEATH CAUSE, EVALUATION OF PROCESSES AND RESULTS (HEALTH CARE)Abstract
Background: evitable death is defined as death caused from diseases or events avoidable by medical intervention or public health measures. Deaths classification based on reducible criteria is a powerful tool to orientate health programs.
Objectives: to determine evitability of deaths occurred at the Pediatric Hospital of the Hospitalarian Centre Pereira Rossell (HP-CHPR) in 2004, 2005, and 2006 in order to orientate health program in the public health sector.
Methods: during 2004, 2005, and 2006 the Audit Committee of Deaths of the HP-CHPR has analyzed and categorize all deaths occurred in that period according to Erika Taucher reducible criteria adjusted to Uruguayan Health Outlines. Deaths were classified as evitable, non-evitable and unknown.
Results: during the mentionned period 279 children died. Evitable deaths represented 56% of the total population (n = 158), 96 were non-evitable deaths and 25 were unknown. For evitable deaths, early treatment and accurate diagnosis could have avoided 78 deaths and health policies, environmental health, sanitary education may have prevented 67.
Discussion: results indicate the failure of the application of preventive measures as well as the need of reinforcing health programs focused to children and may contribute to plan actions.
References
(2) Royer ME, Arbitman JP. Mortalidad infantil evitable. Estudio de su ocurrencia en la ciudad de Buenos Aires y en los hospitales públicos. Año 1994. Rev Med Infant 1997; 4(2):82-7.
(3) Desigualdades en la mortalidad infantil en la región de las Américas: elementos básicos para el análisis. Bol Epidemiol OPS 2001; 22(2):4-7.
(4) Kaempffer AM, Medina E. Análisis de la mortalidad infantil y factores condicionantes. Chile 1998. Rev Chil Pediatr 2000; 71(5):405-12.
(5) Ferrari AM, Ferreira A, De Leonardis D, Fernández A, Imbriaco J. Mortalidad hospitalaria en un hospital pediátrico de referencia nacional: Centro Hospitalario Pereira Rossell. Rev Méd Urug 2002; 18:59-65.
(6) Santoro A, Hackembruch C, Gutiérrez C, Repetto M, De Leonardis D, Rubio I, et al. Evolución de la mortalidad en el hospital pediátrico del Centro hospitalario Pereira Rossell en el período 1999-2002. Informe de Comité de Auditoría de Fallecidos. Arch Pediatr Urug 2003; 74(3):212-8.
(7) Santoro A, Fernández A, Martínez G, Gutiérrez C, Alberti M, Ferrari AM, et al. Informe del Comité de Auditoría de Fallecidos. Hospital Pediátrico del Centro Hospitalario Pereira Rossell. Actualización 2004. Arch Pediatr Urug 2005; 76(2):145-50.
(8) Mortalidad evitable por enfermedad diarreica aguda e infección respiratoria aguda en Puerto Rico (Risaralda). Bol Epidemiol Sem 2003; (19 ene-25 feb. )
(9) Organización Panamericana de la salud/Organización Mundial de la Salud. Niños sanos: la meta de 2002. Washington: OPS/OMS, 2000.
(10) Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS; Bellagio Child Survival Study Group. How many child deaths can we prevent this year? Lancet 2003; 362:65-71.
(11) Uruguay. Ministerio de Salud Pública. División Estadística. Tasas de mortalidad de 1 a 4, 5 a 9 y 10 a 14 años, 2006.
(12) Fernández A, Rodríguez A, Palenzuela S, González N, Gutiérrez MC, Alberti M. El valor de la necropsia en una unidad de cuidado intensivo pediátrico. Arch Pediatr Urug 2001; 72(3): 211-6.
(13) Gutiérrez MC, Rodríguez A, Palenzuela S, Balbela B, Rubio I, Lemes A, et al. Muerte inesperada del lactante. Diagnóstico de situación en la ciudad de Montevideo. Arch Pediatr Urug 2001; 72(3):185-97.
