Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, Chieti.
Postgraduate School of Hygiene and Preventive Medicine, "G. d'Annunzio" University of Chieti-Pescara, Chieti;
Epidemiol Prev. 2020 Sep-Dec;44(5-6 Suppl 1):163-169. doi: 10.19191/EP20.5-6.S1.P163.086.
to estimate and analyse the trend of paediatric hospitalisations for Ambulatory Care Sensitive Conditions (ACSCs) from 2008 to 2018 in a region of southern Italy and to assess the association with the socio-economic deprivation index (DI).
retrospective observational study.
ACSC hospitalisations in children (<=18 years) were identified. Discharges for ACSC of the Abruzzo Region from 2008 to 2018 were selected and the deprivation index of the municipality of residence was assigned to the hospital discharge record where the patient's residence was reported.
the rate of paediatric preventable admissions (PPHs) related to ACSC, standardized by age and gender with the direct method, was calculated for the years of observation. The average annual percentage change (AAPC) was calculated with a trend analysis. In addition, the odds ratios (ORs) of hospitalisation for ACSC were calculated using a hierarchical logistic regression model.
252,513 hospitalisations were examined, of which 16,264 (6.4%) attributable to ACSC. During the study period, the hospitalisation rate decreased from 8.59 per 1,000 to 6.12 per 1,000 residents, with an AAPC of -3.7, which was statistically significant (p<0.05). Furthermore, an association was highlighted between hospitalisations related to ACSC and the deprivation of the municipality of residence. Using as a comparison people residing in the municipalities belonging to the first quintile, the least deprived, the strength of the association between PPHs and DI increased from the third quintile (OR 1.13; CI95% 1.02-1.24) up to the fifth quintile, most deprived (OR 1.14; CI95% 1.01-1.30).
paediatric patients residing in Abruzzo have a risk of undergoing a preventable hospitalisation associated with an ACSC which depends on the deprivation index of the municipality of residence. Although it is difficult to evaluate the mechanisms involved in the relationship between economic deprivation and hospitalisation, DI can be useful to identify the areas which are most at risk on which to prioritize public health interventions.
估计和分析 2008 年至 2018 年意大利南部地区儿童因门诊治疗敏感条件（ACSC）住院的趋势，并评估其与社会经济剥夺指数（DI）的关系。
回顾性观察研究。
确定了儿童（<=18 岁）的 ACSC 住院情况。选择 2008 年至 2018 年阿布鲁佐地区因 ACSC 而住院的患者，并将患者居住地所在市的剥夺指数分配给医院出院记录。
以年龄和性别为标准，用直接法计算观察年份的儿童可预防入院率（PPH）。采用趋势分析计算平均年百分比变化（AAPC）。此外，使用分层逻辑回归模型计算 ACSC 住院的优势比（OR）。
共检查了 252513 例住院病例，其中 16264 例（6.4%）归因于 ACSC。在研究期间，住院率从每千人 8.59 例下降到每千人 6.12 例，AAPC 为-3.7%，具有统计学意义（p<0.05）。此外，还突出了与 ACSC 相关的住院治疗与居住地的贫困程度之间的关系。以居住在第一五分位数（最不贫困）的市的人为比较，PPH 与 DI 之间的关联强度从第三五分位数（OR 1.13；95%CI95%1.02-1.24）增加到第五五分位数（OR 1.14；95%CI95%1.01-1.30），最贫困。
阿布鲁佐的儿科患者因 ACSC 而接受可预防住院治疗的风险取决于居住地的贫困指数。尽管很难评估经济贫困与住院之间关系的机制，但 DI 可以用于识别最危险的地区，并优先考虑公共卫生干预措施。
