This article examines changes in hospital separations of children aged 1 to 14 between 1986/87 and 1996/97. It focuses on four common causes of childhood hospitalization: asthma, chronic disease of tonsils and adenoids, fractures, and acute appendicitis.
Hospital separation data are from the Hospital Morbidity File, from Statistics Canada for fiscal year 1986/87, and from the Canadian Institute for Health Information for fiscal year 1996/97.
Diagnoses were coded to the International Classification of Diseases, Ninth Revision and surgical procedures were coded to the Canadian Classification of Diagnostic, Therapeutic, and Surgical Procedures. Population estimates for 1986 and 1996 were used to calculate hospital separation rates and surgical rates.
In 1986/87, there were 355,000 hospital separations of children aged 1 to 14; by 1996/97, the number of separations had fallen to just over 206,000. The hospital separation rate was 37.0 per 1,000 children in 1996/97, down from 69.7 ten years earlier. The average length of stay fell from 4.5 days to 3.8. The total annual number of days Canadian children stayed in hospital dropped from over 1.6 million to 788,700.
This study discusses the development of the network of baby clinics in francophone Montreal, beginning in the 1910s, which were to be the source of serious conflicts between various advocates, namely, groups of priests and physicians, members of the Saint-Jean-Baptiste National Federation, and municipal government. Child-saving, a fitting nationalist project to bring together elites in the same cause, instead degenerated into a power struggle. Conceived in different terms and after the various political ambitions of the parties became irreconciliable, the organization for the battle against infant mortality in Montreal proved to be a powerful reflection of the discords which separated those who were concerned about the future of the nation and those with ambitions for their personal advancement.
Between August 1990 and December 1993, 140 children underwent Lich-Gregoir antireflux plasty. Twenty-eight boys and 112 girls were included with an age range of 4 months to 15 years (average 5.8 years). Twenty-seven of 220 ureters reimplanted were duplicated. At 6 months follow-up, 10 of 140 children had persistent reflux and 5 had controlateral reflux. Two patients had obstruction and 1 needed reintervention. At 1 year follow-up, only 3 children had persistent reflux and none controlateral. The Lich-Gregoir antireflux procedure is a simple surgery with minimal morbidity and excellent success rate.