Evaluation of Epidemiological and Clinical Characteristics of Pediatric Patients Referred From District Cities of Razavi Khorasan Province To a Public Referral Hospital in Northeast of Iran in 2008-2009

A successful program for patients’ referral from small district medical centers to the public referral hospitals indicates a social development and well-managed healthcare service. This study was done to evaluate the clinical and epidemiological characteristics of pediatric patients referred from district cities to Imam Reza hospital, Razavi Khorasan province as well as assessing the status of the patients’ referral system in 2009-2010. This retrospective cross-sectional study was performed in Imam Reza Hospital in Mashhad, Iran. We evaluated 220 patients who had been referred from Razavi Khorasan district cities to our center in 2009-2010. Demographic characteristics, primary and last diagnosis, and vital signs on admission were recorded and analyzed. A total of 220 patients with mean age of 31± 34 months were recruited in this study. 56% of patients were neonates and infants. There was significant inverse correlation between the length of hospital and the patients’ age as infants aged 0-1 month had the longest duration of hospital stay (6.41± 3.69). The most common primary diagnoses in the origin hospitals included pneumonia (21%), poisoning (15%), and congenital heart disease (11%). These diagnoses were significantly correlated with final diagnoses (P = 0.03, Kappa=0.58). Moreover, a significant correlation between severity of abnormal vital signs and mortality was observed (P = 0.001). In this study we found that neonates had the longest duration of hospital stay. Referral pattern and the relationship between severity of abnormal vital signs and mortality showed that setting up an appropriate protocol for patients’ referral can reduce unnecessary referrals and consequently decrease healthcare costs.