Causes of in-hospital pediatric mortality

Abstract

The purpose of the study is to determine the trends and causes of in-hospital mortality among the children’s population of the Russian Federation, to establish the relationship of its level with the resource provision of medical care. Materials and methods. The level and structure of the causes of in-hospital mortality in children’s population of the Russian Federation over 2015-2020 were studied. The interrelation between its level and the resource provision of medical care for children (medical personnel, bed fund) was established. Results. Against the background of the revealed decrease in the level of in-hospital mortality, unfavourable trends in mortality of children aged 0-17 years from congenital anomalies, diseases of the nervous, endocrine and genitourinary systems were noted. In its structure, the largest share was accounted for by individual conditions of the perinatal period, congenital anomalies and neoplasms. There were similar trends, i.e. gradual decrease, in the trend in in- hospital mortality among children under the age of 1 year of life. However, there was an increase in mortality of children from diseases of the nervous, endocrine systems and neoplasms. In the structure of in-hospital mortality, the largest proportion were individual conditions of the perinatal period, congenital anomalies and diseases of the nervous system. There was an unstable decrease in daily mortality in all age groups. Among those who died on the first day of admission to the hospital, the overwhelming majority were children under 1 year of life. A statistically significant correlation of the level of in-hospital mortality with the provision of medical personnel (pediatricians, and neonatologists) and with the level of their qualifications was revealed. The greatest degree of inverse correlation of hospital mortality was established with the provision of pathology of newborns and premature babies with beds and less (statistically not significant) with pediatric and specialized beds. Conclusion. The level and structure of pediatric in-hospital mortality should serve as an important criterion in assessing the quality of medical care in inpatient medical institutions and be the basis for the development of differentiated measures to reduce it.