Childhood hospitalisation and related deaths in Hanoi, Vietnam: a tertiary hospital database analysis from 2007 to 2014

Abstract

Objective: To describe hospital admission and emergency visit rates and potential risk factors of prolonged hospitalisation and death among children in Hanoi.

Study design: A retrospective study reviewed 212 216 hospitalisation records of children (aged 0-17) who attended the Vietnam National Children's Hospital in Hanoi between 2007 and 2014. Four indicators were analysed and reported: (1) rate of emergency hospital visits, (2) rate of hospitalisation, (3) length of hospital stay and (4) number of deaths. The risk of prolonged hospitalisation was investigated using Cox proportion hazard, and the risk of death was investigated through logistic regressions.

Results: During 2007-2014, the average annual rate of emergency visits was 2.2 per 1000 children and the rate of hospital admissions was 13.8 per 1000 children. The annual rates for infants increased significantly by 3.9 per 1000 children during 2012-2014 for emergency visits and 25.1 per 1000 children during 2009-2014 for hospital admissions. Digestive diseases (32.0%) and injuries (30.2%) were common causes of emergency visits, whereas respiratory diseases (37.7%) and bacterial and parasitic infections (19.8%) accounted for most hospital admissions. Patients with mental and behavioural disorders remained in the hospital the longest (median=12 days). Morbidities related to the perinatal period dominated mortality causes (32.5% of deaths among those admitted to the hospital. Among the respiratory diseases, pneumonia was the leading cause of both prolonged hospitalisation and death.

Conclusions: Preventable health problems, such as common bacterial infections and respiratory diseases, were the primary causes of hospital admissions in Vietnam.

Keywords: emergency visit rate; hospital stay; hospitalization rate; mortality at a hospital; respiratory diseases.

Figure 1

Distribution of the five most frequent diagnoses among (A) emergency visits (2012–2014) and (B) hospital admissions (2007–2014) in Hanoi children, stratified by age group. *Symptoms, signs not elsewhere classified are defined as discharge diagnoses from the International Classification of Diseases, 10th Revision code from R10-R19, which included abdominal or pelvic pain, nausea and vomiting.

Figure 2

Illustrates the time trend of annual hospital admission rates for five specific diseases, namely (A) pneumonia, (B) influenza, (C) asthma, (D) upper respiratory disease and (E) gastroenteritis, for infants and children aged 1–4 years, from 2009 to 2014. Trends were similar for infants and children aged 1–4, in which hospitalisation rates tended to decrease for asthma and gastroenteritis. Admissions due to asthma peaked in 2011 but declined thereafter in both age groups. However, an increasing trend was observed for pneumonia, influenza and upper respiratory diseases. For instance, infant admission rates due to pneumonia increased from 19.2 per 1000 in 2009 to 32.4 per 1000 in 2014.