[Avoidable pediatric hospitalization in the Community of Valencia and Catalonia]. / Hospitalización pediátrica evitable en la Comunidad Valenciana y Cataluña.

OBJECTIVE: To estimate the rates of avoidable pediatric hospitalization in the health areas of the Valencia Community and health sectors of Catalonia, and to analyze if they are related to socioeconomic level or development of primary care. METHOD: Available paediatric (0-14 years old) hospitalizations were analyzed using the Minimum Basic Data Set of Hospital Discharge in two Autonomous Regions: the Valencia Community and Catalonia (1993-1994). Variables analyzed included age, gender, socioeconomic level and coverage by the new model of primary care. Crude and standardized rates for age were calculated and the variation in areas and sectors was assessed. The association between rates and socioeconomic and primary care characteristics was analyzed. RESULTS: Avoidable paediatric hospitalizations represent 21% of all paediatric hospitalizations in the Valencia Community and 15% in Catalonia. Crude rates for Valencia Community ranged between 5.7 and 12.7 in 1993 and 6.6 and 17.8 in 1994; extreme quotient was 2.2 and coefficient of variation 37% in 1993 and 2.7 and 48% respectively in 1994. For Catalonia they ranged between 2.7 and 24.3 in 1993 and 1.4 and 23.8 in 1994; extreme quotient was 9 and coefficient of variation 52% in 1993, and 7 and 42% in 1994 respectively. All these differences were significant (p < 0.005). There was no significant correlation between socioeconomic level and development of primary health care and rates of avoidable paediatric hospitalization by health areas or sectors. CONCLUSIONS: Avoidable paediatric hospitalization represent a significant proportion of paediatric hospitalizations. There are differences in avoidable paediatric hospitalization rates by health areas and sectors, not associated with socioeconomic level and primary care indicators.

[Variations in hospitalization rates for selected surgical procedures. Use of small area analysis]. / Variaciones en la tasa de hospitalización por procedimientos quirúrgicos seleccionados. Aplicación del análisis de areas pequeñas.

The analysis of small area variation (SAV) is useful to correlate hospital utilization rates with supply. In this paper the SAV techniques are applied to 26 areas of Catalonia, whose population is covered by the same hospital or group of hospitals in more than 75% of occasions, and hospitalization rates for several surgical procedures (appendectomy, herniorraphy, cholecystectomy, prostatectomy, hysterectomy, tonsillectomy and lens extraction) are analyzed. For these purposes, 26482 discharges recorded in the Minimum Basic Data Set of Hospital Discharges in 1993 were studied. The obtained results show a great variability between areas, which sometimes is larger than the reported in the literature. For amigdalectomy, the ratio between highest and lowest hospitalization rates is 8.8. For prostatectomy and lens extraction the ratios are 4.8 and 4.5, respectively.

Premature mortality related to AIDS among men and women in Catalonia.

OBJECTIVES: To evaluate the mortality pattern observed in relation to the AIDS epidemic, and to estimate the current and future demographic impact of AIDS among the population aged between 20 and 39 years in Catalonia, Spain. DESIGN: Spain has the highest cumulative incidence rate of AIDS in Europe. One-third of Spanish AIDS cases have been consistently reported from Catalonia, an autonomous region in northeastern Spain with a population of 6 million, and with Pattern I HIV transmission. In this study data from the population-based AIDS registry and death certificates in Catalonia were used. METHODS: Since 1981 AIDS data have been collected routinely from all hospitals using an active surveillance system. All causes of death are coded from death certificates (ICD-9). Mortality rates since 1981 were analysed by age and sex. To assess the relative importance of premature mortality due to AIDS, years of potential life lost (YPLL) before age 65 were used. RESULTS: Since 1982 there has been a continuous increase in crude mortality rates, particularly significant for men aged 20-39 years after 1986 (F < 0.001). While AIDS was the fourth most likely cause of death among people aged 20-39 years in 1988, by 1991 it was the second most likely. In 1990 AIDS contributed to 13,213 YPLL (8.7%) for men and 2579 YPLL (4%) for women. During the last few years AIDS-related deaths have had the highest mortality rate progression among young adults. CONCLUSION: According to the current available data, AIDS might become the leading cause of death for the population aged 20-39 years in the near future. AIDS is having an important impact on the demography of European countries with Pattern I transmission and high HIV prevalence rates.

[Mortality due to accidents in pediatrics. Their causes and frequency]. / Mortalidad por accidentes en pediatría. Causas y frecuencia.

The aim of the study was to ascertain the magnitude, causes and frequency of fatal accidents in Spain in children aged O to 14 years. The information was provided by the Instituto Nacional de Estadística. The latest data published for the five years 1982 to 1986 inclusive are studied and the causes of death by accident evaluated.