An estimation of compliance of acute community-acquired pneumonia detection in children with local healthcare protocols

Aim. To study the rationale for the diagnostic tests use and their compliance with the lists recommended by local protocol of healthcare for acute community-acquired pneumonia in children and to develop management measures to improve the diagnosis of the disease.Methods. Methods of comparative and statistical analysis were applied to assess the use of diagnostic tests conducted in 2011 at the prehospital and hospital stages in 240 children admitted to Children’s Regional Hospital, Chernigov, Ukraine depending on patients’ age and severity of the acute community-acquired pneumonia.Results. It was found that the list and the conduction of the diagnostic tests in children with moderately severe pneumonia deviated from the recommended national protocol requirements without reasonable clinical indications. Additionally to the obligatory tests (full blood count, chest X-ray) every second child was administered electrocardiography, and every fifth - liver function test. Chest X-ray was re-done in 14.4% of children aged 1-3 years and 12.0% of children aged 4-16 at admission. Low coverage level with examinations performed on out-patient stage in children regardless of their clinical condition was revealed, leading to a waste of resources of the hospital for the diagnosis of the disease.Conclusion. The results of the study demonstrate the need for adopting and implementing the management decisions to improve the diagnosis of acute community-acquired pneumonia in children based on the obtained evidence.