Analysis of Pediatric Medical Admission Pattern to a Tertiary Care Hospital: Issues for Future Planning

Objectives: To determine current pattern of admissions and their outcomes in relation to disease along with referral mode at a Pediatric Medical Unit of a tertiary Care Hospital. Material and Methods: A descriptive study was carried out at West Medical Unit of The Children’s Hospital Pakistan Institute of Medical Sciences (PIMS) Islamabad over a period of one year. All the admissions were analyzed for age, residence, mode of admission and referral source. Final diagnosis and outcome, grouped according to involved organ system was analyzed. Results: Two thousand one hundred and twenty-four patients with male to female ratio of 1.5:1 were admitted in one year. Seventy percent of the patients were younger than 5years and 37% less than one year. Respiratory, neurologic, oncologic conditions and non-specific infection were the main diseases. Mortality was 8.9% and it was highest in nonspecific infection group followed by neurologic, respiratory and renal diseases. Mean duration of stay was 7.6 days. Most patients were admitted through Accident and Emergency(A E) Department and came directly to the hospital. Fifty percent of admissions were from Rawalpindi and Islamabad. Twenty-five percent were from other cities of Punjab. A significant number came from Azad Jammu Kashmir(AJK) and North Western Frontier Province(NWFP). Conclusion: Under five-year patients contribute to 2/3rd of hospital admissions. Non-specific infection, respiratory or neurologic diseases are main pathologies and they have main contribution to death as well. Most of the patients approach directly tertiary care hospital. There is a need for development of community base services.