[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.

[Allergic sensitization profile in 0-5 year old children with wheezing and/or atopic dermatitis]. / Perfil de sensibilización alérgica en niños de 0 a 5 años con sibilancias o dermatitis atópica.

BACKGROUND: Although allergic diseases are frequent in childhood, few studies have characterised the IgE sensitization profile among young children with allergic-like symptoms. OBJECTIVE: To determine the prevalence and the type of allergic sensitization, as well as the demographic and environmental factors related to both characteristics, among 0-5 year old children presenting with wheezing and/or atopic dermatitis. METHODS: Collaborative cross-over study developed in the paediatric setting of 20 Spanish Primary Health Care Centres. An allergology evaluation including blood determination of specific IgE antibodies to common inhalant and food allergens was performed on 468 children who presented with wheezing and/or atopic dermatitis. RESULTS: Allergic sensitization was detected in 32.4% of the children with wheezing (95% confidence interval, 95%CI, 26.3-38.6%), in 54.8% of the children who had atopic dermatitis (95%CI, 42.1-67.6%) and in 39.2% of the children with both processes (95%CI, 32.0-46.4%). The risk of allergic sensitization was sex related (male versus female adjusted odds ratio, OR(A), 1.91, 95%CI, 1.24-2.95), and also related to the age (3-5 versus 0-2 year old OR(A) 1.96, 95%CI, 1.27-3.0), type of early feeding (maternal milk versus infant formula OR(A) 0.51, 95%CI, 0.31-0.84) and geoclimatic area (OR(A) Continental versus Atlantic 2.26, 95%CI, 1.30-3.93). Compared to the Atlantic area, the Continental area the sensitization was lower to mites (OR(A) 0.16, 95%CI, 0.07-0.36) and higher to grass (OR(A) 4.65, 95%CI 1.99-10.86), cow milk (OR(A) 5.17, 95%CI, 1.71-15.62) and egg (OR(A) 5.26, 95%CI, 2.04-13.62), whereas in the Mediterranean area the sensitization was lower to mites (OR(A) 0.29, 95%CI, 0.13-0.64) and higher to cow milk (OR(A) 3.81, 95%CI, 1.20-12.14) and egg (OR(A) 5.24, 95%CI, 1.94-14.20). CONCLUSION: A significant proportion of small children treated at the paediatric primary health care centres due to wheezing and/or atopic dermatitis had allergic sensitization. There appears to be a geoclimatic variation in the prevalence of sensitization to inhalant and food allergens among young children with allergic like symptoms who live in Spain.