Childhood death auditing to improve paediatric care
Childhood death auditing to improve paediatric care
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DOI：
10.1080/08035250600746302
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发表时间：
2006-11-01
期刊：
影响因子：
3.8
通讯作者：
Stephen, Cindy
中科院分区：
文献类型：
--
作者：
Krug, Angelika;Patrick, Mark;Stephen, Cindy
目标：在南非八个地点对儿科死亡率审计系统进行现场测试，以评估其可行性，收集有关 5 岁以下儿童常见死因的当地数据，并确定卫生系统失败、错过的干预机会和不合格的护理（可修改因素）。方法：该研究测试了 5 岁以下医疗保健问题识别计划 (U5PIP)。这些网站代表了不同级别的儿科医疗保健。研究期间：2003年9月1日至2004年8月31日。研究人群：研究医院收治的5岁以下患者。病例：在研究医院死亡的 5 岁以下患者。结果：共有 1532 名 5 岁以下儿童死亡，病死率为 7.8%。主要死因是下呼吸道感染（33%）、胃肠炎（15%）和败血症（12%）。百分之六十的死亡与艾滋病毒/艾滋病有关。百分之六十九的死亡儿童体重不足。 31% 的死亡存在行政可改变因素。在诊所层面检测到与临床人员相关的可修改因素的比例为 26%，在医院层面检测到的比例为 33-37%。结论：U5PIP 对于儿科团队作为日常工作的一部分进行持续死亡率审查是可行的。本研究中有关常见死亡原因和可改变因素的信息重点关注艾滋病毒/艾滋病、营养不良和资源分配的影响，可用于改善儿科医疗保健的干预措施。
Aim: Field-testing a paediatric mortality audit system at eight sites in South Africa to assess its feasibility, to collect local data on common causes of death in children under 5 y, and to determine health system failure, missed opportunities of intervention and substandard care ( modifiable factors). Methods: The study tested the Under-5 Healthcare Problem Identification Programme (U5PIP). The sites represent different levels of paediatric healthcare. Study period: 1 September 2003-31 August 2004. Study population: Under-5 patients admitted to study hospitals. Cases: Under- 5 patients who died in study hospitals. Results: In total, 1532 under-5 deaths occurred, representing a case-fatality rate of 7.8%. Main causes of death were lower respiratory tract infections (33%), gastroenteritis (15%) and septicaemia (12%). Sixty per cent of the deaths were HIV/AIDS related. Sixty-nine per cent of children who died were underweight. Administrative modifiable factors were present in 31% of deaths. Clinical personnel-related modifiable factors were detected in 26% at the clinic level and in 33-37% at the hospital level.Conclusion: The U5PIP is feasible for ongoing mortality reviews by paediatric teams as part of routine work. Information on common causes of death and modifiable factors in this study focus on the impact of HIV/AIDS, malnutrition and resource allocation, and can be used for interventions to improve paediatric healthcare.