Article du mois d'Aout 2018 des Archives de Pédiatrie :Social deprivation in pediatric departments

Impact of social deprivation on length of stay for common infectious diseases in two French university affiliated general pediatric departments 

A. Roussel , M. Michel, A. Lefevre-Utile,  L. De Pontual , A. Faye , K. Chevreul

Background:Adult deprived patients consume more healthcare resources than others, particularly in terms of increased length of stay (LOS) and costs. Very few pediatric studies have focused on LOS, although the effect of deprivation could be greater in children due to the vulnerability of this population. 

Our objective was to compare LOS between deprived and nondeprived children hospitalized for acute infectious diseases in two university-affiliated pediatric departments located in a low-income area of northern Paris. 

Methods:We performed a prospective observational multicenter study in two university-affiliated hospitals, Hôpital Robert-Debré and Hôpital Jean-Verdier. All the patients under 15 years of age admitted to the general pediatric department for pneumonia, bronchiolitis, gastroenteritis, or pyelonephritis between 20 October 2016 and 20 March 2017 were included. Deprivation was assessed with an individual questionnaire and score (EPICES). Endpoints included length of stay, costs, and readmission rates at 15 days in each quintile of deprivation. Multivariate regression assessed the association between deprivation and each endpoint. 

Results:A total of 556 patients were included in the study and 540 were analyzed. Sixty percent were boys and the mean age was 9 months  _ 18. Bronchiolitis was the most frequent diagnosis (67.8%). Fifty-six percent of patients were considered to be deprived based on the EPICES questionnaire. Mean LOS was 4.6  _ 3.5 days and we found no significant difference in LOS between the different deprivation quintiles (P = 0.83). Multivariate regression did not show an association between LOS and deprivation. 

Conclusion:There was no difference between deprived and nondeprived patients in terms of LOS. Deprivation may therefore impact hospitals in other ways such as admission rates. The impact of deprivation during hospitalization for chronic diseases should also be investigated.