Pediatric Hospitalization for Varicella in an Italian Pediatric Hospital: How Much Does It Cost?

Background: Varicella is a common pediatric infection. Even if it generally has a benign course, it may complicate and require hospitalization. The aim of our study was to estimate the acute hospitalization cost (AHC) for varicella in the acute phase in a pediatric population. Methods: We calculated the AHC of pediatric patients admitted for varicella at Bambino Gesù Children Hospital, Rome, Italy, from 1 November 2005 to 1 November 2020. Results: In the study period, 825 pediatric patients affected by varicella were hospitalized. The mean hospitalization cost was EUR 4015.35 (range from EUR 558.44 to EUR 42,608.00). Among patients, 55% were unvaccinable due to either their age or their immunosuppression status. They would benefit from herd immunity, reducing the overall AHC by EUR 182,196,506. Since the introduction of the compulsory vaccination against varicella in Italy, we observed a significant reduction in AHC cost of 60.6% in 2019 and of 93.5% in 2020. Finally, from the beginning of the COVID-19 pandemic, we documented a decline of 81.2% and 76.9% in varicella hospitalization, compared to 2018 and 2019, respectively. Conclusions: Varicella AHC is an important economic and health assessment point and can be useful for improving preventive strategies.

“Placebo Tests” for the Impacts of Air Pollution on Health: The Challenge of Limited Health Care Infrastructure

"Placebo tests" are normally used to support evidence of pollution impacts on health outcomes. In this study, we argue that one should be cautious to proceed with falsification tests. We examine how a large metropolitan area in Brazil copes with increased health-care demand due to high air pollution under hospital capacity constraints. Using wind as an instrument, we find that the pollution exposure increases pediatric hospitalization for respiratory diseases while the number of planned procedures decreases in public hospitals. On average, for every four additional pollution-related admissions, one elective care procedure is displaced. Urgent procedures are not displaced.

Playful strategies in the pediatric hospitalization scenario

Childhood is a phase of life that, for the most part, is symbolized by the act of playing. It is through this stage that the child has new skills, experiences, and discoveries. In addition, one can also notice the development of processes such as creativity, self-confidence, social-affective relationships, and cognition. However, some situations sometimes hinder the realization of processes that are essential for childhood, hospitalization being one of them. The study aims to know the playful strategies in the scenario of pediatric hospitalization, highlighting its benefits and importance in hospital humanization. This is an integrative review, carried out from articles collected from the Scielo, PubMed, Lilacs, Medline and BDENF databases. The descriptors applied were "Child Health" AND "Play Therapy". The findings showed that play strategies are extremely important in the humanization of care for hospitalized children, as they reduce suffering and make hospitalization less painful and traumatic. It was concluded that playful strategies when implemented in the pediatric hospital setting promote a less traumatic recovery, in addition to allowing for greater tranquility in the hospital environment. Moreover, the use of playful strategies was pointed out by the studies as a communication resource that benefits not only the physical, emotional, and immunological stimuli, but also the relationship between the child and the health professional, thus contributing to a greater trust in the therapy adopted and in the multiprofessional team.