Currents state of in-patient care for children population

Abstract

In-patient care traditionally takes a leading place in the system of medical care for children. Within its framework, urgent and important tasks of the Government in the field of healthcare are being solved to reduce infant and child mortality, disability, and combat the progressive course of chronic diseases, and disability.
Purpose — to conduct a retrospective analysis and assessment of the status of in-patient care for the children's population, to determine trends in its availability and effectiveness.
Patients and methods. The analysis was performed using data from the State Statistics Service of Ukraine and the State Institution «Center for Medical Statistics of the Ministry of Health of Ukraine» for the period 1990–2019. The methods of a systematic approach, structural-logical, epidemiological analysis are used.
Results. The data of the research demonstrated that the state system of in-patient care for children was introduced after 1917, and in 1948 the creation of children's hospitals combined with the clinic began. Further on, there was an increase in the bed fund capacity for children and an increase in the provision of beds for children in the absence of the evidence-based standards. The extensive development of the healthcare system, when, with insufficient funding, all efforts were aimed at increasing children's hospitals and building up a hospital fund for children, led to the prevalence of a hospital with low resources in the structure of hospital facilities for children. Only during the years of Ukrainian sovereignty Ukraine has streamlined the bed fund capacity and reduced the number of low-cost, economically unprofitable hospitals: since 1991, 51.1 thousand baby beds have been reduced. Now in Ukraine there are 39.5 thousand beds for children, 53.2% of which are deployed in independent children's hospitals (28 regional children's, 49 city children's, 3 infectious children's and 2 children's tuberculosis). It has been established that currently the accessibility and quality of hospital care for children is preserved in Ukraine (in 2019, the hospitalization rate was 185.7 per 1000 children, the total mortality rate was 0.17%, the mortality rate of children under one year old was 0.93%, and the postoperative mortality rate was 0.33% at 172.3, 0.33%, 1.06% and 0.11% respectively in 2000), the efficiency of using the bed fund capacity (bed turnover — 22.97 in 2000 and 32.89 in 2019).
Conclusions. It is appropriate to direct the improvement of the in-patient sector of pediatric care in modern conditions to transformation of in-patient care to financing on the basis of the finished case, developing of the optimized forms of its provision, creation of telecommunication links between specialists and institutions of state and public structures, forming of a unified monitoring and evaluation system.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of this Institute. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest were declared by the authors.