Indian Journal of Pediatrics
Volume 86, 2019, Pages 3-9

The Role of Maternal Citizenship on Pediatric Avoidable Hospitalization: A Birth Cohort Study in North-East Italy (Review)

Bardin A. , Dalla Zuanna T. , Favarato S. , Simonato L. , Zanier L. , Comoretto R.I. , Canova C.*
  • a Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
  • b Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
  • c Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
  • d Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
  • e Epidemiological Service, Health Directorate, Friuli Venezia-Giulia Region, Udine, Italy
  • f Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
  • g Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy

Abstract

Objective: Avoidable hospitalization (AH) has been widely studied as a possible measure of primary health care performance. Since studies evaluating AH in migrant children, particularly in Europe, are lacking, the aim of this study was to investigate the role of maternal citizenship on the risk of AH in children. Methods: The cohort study included all live newborns recorded in the Medical Birth Register (MBR) of Friuli-Venezia Giulia Region (Italy) in the years 1989–2012, followed from 30 d after their birth up to the 14th year of life. Cox regression models were used to estimate Hazard Ratios (HRs) for any AH and for specific conditions. Results: Among the 213,635 children included in the cohort, authors identified 23,011 AHs in 16,744 children, most of which occurred between 1 and 4 y of age. Children born to mothers from High Migration Pressure Countries had a higher risk of AH for any condition (HR 1.35; 95% CI = 1.27–1.44) than children born to Italian mothers. The risks were higher concerning gastroenteritis (HR 1.74; 1.57–1.94), upper respiratory tract infections (HR 1.58; 1.35–1.84), asthma (HR 1.53; 1.12–2.06) and bacterial pneumonia (HR 1.18; 1.01–1.37). There were no differences in urinary tract infections, short term complications of diabetes and perforated appendix. Conclusions: Despite the inclusiveness and universality of the Italian healthcare system, children born to immigrant mothers experienced more need of avoidable hospital care than children born to Italian mothers. Access barriers to primary care are plausible causes for the observed disparities. © 2019, Dr. K C Chaudhuri Foundation.

Author Keywords

Migration Socio demographic factors Avoidable hospitalization Italy Children maternal citizenship

Index Keywords

proportional hazards model hospitalization regression analysis Maternal Age urinary tract infection gastroenteritis upper respiratory tract infection Hospitals, Pediatric human Cohort Studies ethnology hospital care Humans migrant Infant, Newborn male asthma female preschool child Emigrants and Immigrants risk factor Risk Factors Infant Child, Preschool newborn Review Mothers birth certificate mother Urinary Tract Infections cohort analysis Italy appendix perforation health care system hospital Birth Certificates Delivery of Health Care avoidable hospitalization bacterial pneumonia Healthcare Disparities citizenship health care disparity gestational age primary health care health care delivery
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85059848100&doi=10.1007%2fs12098-018-2826-6&partnerID=40&md5=e99beafe03070f729c11652460b0a450
DOI: 10.1007/s12098-018-2826-6
ISSN: 00195456
Cited by: 1
Original Language: English