Profile of spontaneous demand for services among infants younger than 30 days old at a children’s tertiary care hospital

Abstract

In recent years, admission of critical newborn infants (NBIs) to the neonatal intensive care unit of Hospital Garrahan (HG) has been limited due to the hospitalization of infants younger than 30 days old through spontaneous demand for services. This is probably a multifactorial situation, and one of its causes is a lack of regionalization, which results in an inadequate use of resources or a distorted use of resources intended for more complex care. The objective of this study was to establish the profile of NBIs who make a spontaneous demand for services at HG and to assess the level of care required based on their medical condition. Material and methods. Cross-sectional study. All infants ≤ 30 days old who sought care at HG in a period of 12 months were assessed. The analysis included clinical characteristics of NBIs, prior visits, parental reason for consultation at HG, and whether NBIs could have been seen at a primary or secondary care facility. Results. A total of 307 consultations were analyzed; NBI age was 18 days ± 7.6. Of these, 78% required hospitalization. The most common reason for hospitalization was acute respiratory tract infection. Thirty-five percent had health insurance coverage; 54% had sought care more than once at a different facility. Only 15% of NBIs had a highly complex condition that should have actually been solved at HG. Conclusion. Based on the analysis of NBIs seen at HG through spontaneous demand for services, a high requirement of hospitalization for low and medium complexity pathologies was observed.