[What would happen if day care centers closed?]. / Qué pasaría si cerrasen las guarderías?

OBJECTIVE: To determine the possible association between the decrease in emergency episodes and the strike in day care centers in Vitoria (Spain) in the autumn of 2004, which affected 86 % of children attending these centers. PATIENTS AND METHOD: We performed a retrospective observational study. In Vitoria, there were 27404 children under the age of 14 in 2004; of these, 5890 were under the age of 3 years. The day care centers on strike affected 25.4 % of the latter. We compared emergency episodes and hospital admissions during the strike (September to November, 2004) with those occurring in the previous 5 years. To contrast the hypothesis, a comparison of proportions was used with statistical significance set at p < 0.005. RESULTS: A significant decrease (rate x 1000 inhabitants) was observed in the number of emergency episodes in children under 3 years old in two of the three months of the strike (October and November, p < 0.01). No significant differences were observed in emergency rates in children aged more than 3 years old, or in hospital admissions in all ages. CONCLUSIONS: These data suggest that children attending day care centers have a higher risk of catching banal diseases (which do not require hospital admission and are probably infectocontagious illnesses) than children not attending these centers, thus increasing demand for pediatric emergency services. Since the solution does not lie in closing day care centers, hygienic and sanitary measures should be maximized in these centers.

¿Qué pasaría si cerrasen las guarderías? / What would happen if Day care centers closed?

Objetivo Establecer una relación entre el descenso en la demanda de urgencias pediátricas y la huelga de guarderías acontecida en Vitoria en otoño de 2004, que afectó al 86 % de los niños que a ellas acudían. Pacientes y método Estudio observacional, retrospectivo. En Vitoria, el número de menores de 14 años en 2004 era de 27.404 siendo 5.890 menores de 3 años. Las guarderías en huelga afectaron al 25,4 % de los niños menores de 3 años. Se compararon los episodios de urgencias y la hospitalización durante los meses de huelga (septiembre a noviembre de 2004), y de los últimos 5 años. Para el contraste de hipótesis se empleó la comparación de proporciones con un nivel de significación estadística inferior a 0,05. Resultados Se observó una disminución significativa (expresadas en tasa × 1.000 habitantes) en la demanda de urgencias en los niños menores de 3 años de edad, en 2 de los 3 meses que duró la huelga (octubre y noviembre; p < 0,01). No se apreciaron diferencias significativas en la demanda de urgencias en mayores de 3 años ni se observó una variación en la hospitalización. Conclusiones Estos datos sugieren que los niños que acuden a las guarderías presentan mayor riesgo de contraer enfermedades banales (que no precisan hospitalización y probablemente son infectocontagiosas), que los que no acuden; aumentando de este modo la demanda de atención en los servicios de urgencias pediátricos. Sabiendo que la solución no está en cerrar las guarderías, es preciso extremar las medidas higiénico-sanitarias en dichos centros

Objective To determine the possible association between the decrease in emergency episodes and the strike in day care centers in Vitoria (Spain) in the autumn of 2004, which affected 86 % of children attending these centers. Patients and method We performed a retrospective observational study. In Vitoria, there were 27404 children under the age of 14 in 2004; of these, 5890 were under the age of 3 years. The day care centers on strike affected 25.4 % of the latter. We compared emergency episodes and hospital admissions during the strike (September to November, 2004) with those occurring in the previous 5 years. To contrast the hypothesis, a comparison of proportions was used with statistical significance set at p < 0.005. Results A significant decrease (rate × 1000 inhabitants) was observed in the number of emergency episodes in children under 3 years old in two of the three months of the strike (October and November, p < 0.01). No significant differences were observed in emergency rates in children aged more than 3 years old, or in hospital admissions in all ages. Conclusions These data suggest that children attending day care centers have a higher risk of catching banal diseases (which do not require hospital admission and are probably infectocontagious illnesses) than children not attending these centers, thus increasing demand for pediatric emergency services. Since the solution does not lie in closing day care centers, hygienic and sanitary measures should be maximized in these centers