Improving quality of care: strengthening primary health care by avoiding unnecessary hospitalizations in Romania: health systems evaluation report

Abstract

Observations from completed WHO missions show that children and pregnant women with common conditions are often admitted to hospital when they could be safely managed in primary care. Previous observations also suggest that treatment of common childhood conditions often comprises multiple unnecessary and invasive drugs, which are not evidence-based and not in line with international guidelines. With the overall goal of strengthening primary health care (‎PHC)‎ in Romania, this health systems evaluation was carried out for three principal purposes: (‎1)‎ to determine hospitalization rates in children and pregnant women between 2011 and 2020/2021 and to identify the main causes of hospitalization; (‎2)‎ to quantify and understand the reasons for unnecessary and unnecessarily prolonged hospitalizations in children, pregnant women and women hospitalized for delivery; and (‎3)‎ to assess and quantify antibiotic use and polypharmacy in children and pregnant women admitted to hospital for common conditions.