Hospitalizations of children with sickle cell disease in the Brazilian Unified Health System in the state of Minas Gerais

• Main Authors: Ana Paula P.C. Fernandes (Author), Fernanda A. Avendanha (Author), Marcos B. Viana (Author)
• Format: Book
• Published: Brazilian Society of Pediatrics, 2017-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2255-5536; 10.1016/j.jpedp.2016.12.003
• Keywords: Sickle cell disease; Hospital Admitting Department; Epidemiology; Health system; Newborn screening; Brazil; Pediatrics; RJ1-570
• Source: Jornal de Pediatria (Versão em Português), Vol 93, Iss 3, Pp 287-293 (2017)

Objective: To identify and characterize hospital admissions and readmissions in the Brazilian Unified Public Health System (Sistema Único de Saúde [SUS]) in children with sickle‐cell disease diagnosed by the Minas Gerais Newborn Screening Program between 1999 and 2012. Methods: Hospital Admission Authorizations with the D57 (International Classification of Diseases‐10) code in the fields of primary or secondary diagnosis were retrieved from the SUS Databank (1999-2012). There were 2991 hospitalizations for 969 children. Results: 73.2% of children had hemoglobin SS/Sβ0‐thalassemia and 48% were girls. The mean age was 4.3 ± 3.2 years, the mean number of hospitalizations, 3.1 ± 3.3, and the hospital length of stay, 5 ± 3.9 days. Hospital readmissions occurred for 16.7% of children; 10% of admissions were associated with readmission within 30 days after discharge; 33% of readmissions occurred within seven days post‐discharge. There were 41 deaths, 95% of which were in‐hospital. Secondary diagnoses were not recorded in 96% of admissions, making it impossible to know the reason for admission. In 62% of cases, hospitalizations occurred in the child's county of residence. The total number of hospitalizations of children under 14 with sickle‐cell disease relative to the total of pediatric hospitalizations increased from 0.12% in 1999 to 0.37% in 2012. Conclusions: A high demand for hospital care in children with sickle‐cell disease was evident. The number of hospitalizations increased from 1999 to 2012, suggesting that the disease has become more "visible". Knowledge of the characteristics of these admissions can help in the planning of care for these children in the SUS.