Influence of child day-care centres on morbidity and consumption of health resources in children younger than 2 years.

Objective: to evaluate the influence of child day-care centres on morbidity and consumption of health resources in children younger than 2 years.

Methods: design: prospective longitudinal study. Participating institutions: Primary Health Care centers, coordinated by “Grupo de Investigación de la Asociación Española de Pediatría de Atención Primaria” (AEPap) (Research Group of the Spanish Primary Care Pediatrics Association).  Subjects: children aged 0 to 2 years attending pediatric appointments of the participating health centres. Sample: all children born between April 1st and October 30th, 2009, that meet the inclusion criteria. Variables: independent variable will be Child day-care center or not. As dependent variables it will be analyzed the number and type of infection, treatments received and assistance to Health Care centers. Characterization personal and family variables that could act as confounding factors will be also collected. Data collection: interviews conducted during the first visit and at 6, 12, 18 and 24 months of age. Statistical analysis: to analyze the differences between number of infections depending on age of child when entering child day-care center, an Anova test will be done. We will apply Student’s T test or Mann-Whitney´s U test to compare antibiotic consumption, use of bronchodilators, health resource utilization among children attending child day-care center and those who don’t. A multivariate lineal regression analysis will be done step by step to identify personal and family factors that may be considered as predictors of the number of infections after controlling potential confounders and interaction factors.