[Analysis of pediatric «short stays¼ in a second-level hospital throughout 25 years]. / Análisis de las «estancias cero¼ pediátricas en un hospital de nivel 2 a lo largo de 25 años.

INTRODUCTION: It is essential to admit patients to hospital in an efficient way in order to use resources rationally. Short hospitalary stays are hospitalizations which does not include 00:00h and are considered avoidable. This study describes trends and characteristics of short stays throughout 25 years in our hospital. PATIENTS AND METHODS: We analyzed hospital pediatric discharges in a second-level hospital through the registration system «conjunto mínimo básico de datos¼. We categorized pediatric patients and newborn patients in two groups according to length of hospital stay: «short stays¼ and «prolonged stays¼. We analyzed and compared the following variables: gender, age, type of admission, month, diagnosis-related groups (DRG) and admission service. Binary logistic regression analysis and assessment of trends through joinpoint regression analysis were performed. RESULTS: From 1993 to 2017, 45710 children were admitted to our hospital, of which 7.3% were short stays. The trend analysis showed a point of change upwards-downwards at the beginning of the millennium. Pediatric short stays: the most important variables were emergency admissions (89%), urgent transfers (9%), month December (11%) and main diagnosis category: nervous system (18%). Mean diagnosis-related groups cost was 2432±1115€ in short stays group and 2549±1065€ in prolonged stays. CONCLUSIONS: Short stays and prolonged stays show a falling trend in our hospital. Short stays percentage in our environment is similar to other neighbor countries. Some of our short stays are urgent transfers and admissions for clinical observation. We did not find clinical significance in weight or cost of pediatric patients' DRG comparing to prolonged stays.

[Impact of COVID-19s alarm states in the care of pediatric patients in Primary Care in a health area in northern Spain]. / Impacto de los estados de alarma por COVID-19 en la atención a pacientes pediátricos en Atención Primaria de un área sanitaria del norte de España.

AIM: The SARS-CoV-2 pandemic has meant a global change in the healthcare model, enhancing telematic assistance, specially at the Health Primary Care (PC). There are few studies that relate the attendance of children at the PC to the pandemic of COVID-19. The aim of our study is to describe the impact of the two Spanish states of alarm on the care of children at de PC level. MATERIAL AND METHODS: Retrospective observational study. The PC visits corresponding to pediatric patients (<14 years) from a health area in northern Spain during the first and second states of alarm were analyzed, and compared with their equivalent periods in 2019. RESULTS: During the first state of alarm, home lockdown and school closure were established, and a large decrease in pediatric visits to the health centres was observed (758 vs. 1381 in 2019) at the expense of health check-ups and infectious diseases. This decrease was not observed in the second state of alarm (1375 vs. 1233 in 2019). In both states of alarm, the percentage of telephone assistance increased significantly. CONCLUSIONS: The implementation of alarm states has meant a decrease on the demand of medical care, especially during the first state of alarm, may be owing to the fear of the families of going to the health center and the decrease in the transmissibility of viruses due to home lockdown. The increase of the telematic assistance has been on account of the need of reorganization of health care, wich has proven to be effective.