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

doi:10.1016/j.arcped.2018.06.003

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

Arch Pediatr. 2018 Aug;25(6):359-364. doi: 10.1016/j.arcped.2018.06.003. Epub 2018 Jul 21.

Authors

A Roussel¹, M Michel², A Lefevre-Utile³, L De Pontual⁴, A Faye⁵, K Chevreul²

Affiliations

¹ Service de pédiatrie générale, hôpital Robert-Debré, Assistance publique des Hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France; Inserm, ECEVE, U1123, 10, boulevard de Verdun, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 10, boulevard de Verdun, 75010 Paris, France. Electronic address: aphaia.roussel@aphp.fr.
² Inserm, ECEVE, U1123, 10, boulevard de Verdun, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 10, boulevard de Verdun, 75010 Paris, France; URC Eco Île-de-France, DRCD, Assistance publique-Hôpitaux de Paris, Hôtel Dieu, 1, place du Parvis-de-Notre-Dame, 75004 Paris, France.
³ Service de pédiatrie générale, hôpital Robert-Debré, Assistance publique des Hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France.
⁴ Service de pédiatrie générale, hôpital Jean-Verdier, Assistance publique-Hôpitaux de Paris, avenue du 14-Juillet, 93143 Bondy cedex, France.
⁵ Service de pédiatrie générale, hôpital Robert-Debré, Assistance publique des Hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France; Inserm, ECEVE, U1123, 10, boulevard de Verdun, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, 10, boulevard de Verdun, 75010 Paris, France.

PMID: 30041884
DOI: 10.1016/j.arcped.2018.06.003

Abstract

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.

Keywords: Acute infectious diseases; Children; Deprivation; Length of stay.

Publication types

Comparative Study
Multicenter Study
Observational Study

MeSH terms

Adolescent
Child
Child, Preschool
Communicable Diseases / epidemiology*
Female
Hospitalization / statistics & numerical data
Hospitals, University / statistics & numerical data
Humans
Infant
Infant, Newborn
Length of Stay / statistics & numerical data*
Male
Paris / epidemiology
Patient Readmission / statistics & numerical data
Prospective Studies
Psychosocial Deprivation*
Surveys and Questionnaires