Pediatric hospitalizations at two different setting community hospitals in north India: implications for regionalization of care.

Objective: To evaluate pediatric hospitalizations at two different setting community hospitals in north India, and to understand the implications for regionalization of pediatric care in heterogeneous environment of India.

Methods: Retrospective review of medical records of children hospitalized at a large and a small community hospital catering to population from different social classes but in close proximity to each other was carried out. Baseline characteristics and diagnosis were recorded, and compared using appropriate statistical tests.

Results: There were notable differences between the age and morbidity profiles at the two study hospitals. Smaller community hospital catered to more young, malnourished and sicker children. Morbidity profile comprised of significantly more acute gastroenteritis and community-acquired pneumonia at the small hospital. In contrast, almost a quarter (24.4%) of children was injured at the larger community hospital. Infants and newborns were more at small, while older children (>5 yrs) were more at the larger community hospital (p<0.0001).

Conclusion: The conclusion drawn from this study is that significant differences exist in age and morbidity profiles between different setting community hospitals in north India. There is a need to form a prospective registry of community hospitals, which would validate the observations of the present study, and has implications for regionalization of specialized pediatric services as well as postgraduate training in India.