On the effectiveness of inpatient treatment of children with comorbid pathology

Author:

Konovalov Oleg E.1ORCID,Modestov A.A.2ORCID,Ulishchenko I.A.1ORCID,Gudkov R.A.3ORCID

Affiliation:

1. Russian Peoples Friendship University

2. N.I. Pirogov Russian National Research Medical University

3. I.P. Pavlov Ryazan State Medical University

Abstract

Introduction. A comprehensive approach in providing of medical aid to a child with comorbid pathology is intended to mean that child receives high-quality diagnostics, treatment, rehabilitation and informational support in the full extent in regard to all the diseases child has. The main problems of this category of patients are need of expanding treatment and diagnostic activities, attracting of consultants and also increasing of resource costs and breakdown of response to treatment. The goal of research is to study the efficiency of hospital treatment of children with comorbidities in complex examination and treatment. Material and methods. It was examined 616 children aged 7-14 years, hospitalized for asthma. At the same time, 368 children had comorbidities. One half of patients with comorbid pathology received a comprehensive examination and taking into account comorbidities, the other half - a standard set of examination and treatment of the main disease. The survey of parents and catamnestic observation of patients for 1 year was carried out. Results. The presence of comorbidities in children with bronchial asthma, in particular the obesity and gastroenterological diseases, has a significant negative impact on the course of asthma, the efficiency of its therapy and the need for medical aid. The results of the study showed that children with high levels of comorbidity have more frequent and prolonged hospitalizations. Comprehensive screening and early treatment of comorbidities reduces the incidence of exacerbations, the risk of emergency hospitalizations and improves asthma control. Discussion. An increase in the duration of hospitalization of patients with comorbid pathology may be associated with a severity of the main illness and a lower rate of response to therapy, possibly with reduced compliance. Although the presence of comorbidities contributes to the lengthening of hospitalization, a comprehensive examination and treatment does not increase the duration of the child’s stay in the hospital. Conclision. The expansion of diagnostic and therapeutic actions in relation to concomitant diseases in a patient with bronchial asthma within the framework of hospitalization increases the clinical and economic efficiency of treatment measures, reduces the subsequent burden on the hospital and out-patient hospital, increases the assessment of medical care by parents and their adherence to the prescribed treatment.

Publisher

Federal Scientific Center for Hygiene F.F.Erisman

Subject

Public Health, Environmental and Occupational Health,Health Policy

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