Regional differences in postneonatal childhood mortality in Finland, 1985-2004.

AIM: The Finnish healthcare system will undergo a major reform in the near future. This study examined whether postneonatal childhood mortality differed between university and central hospital districts in Finland from 1985 to 2004 and whether the causes of death were preventable.
METHODS: We analysed postneonatal childhood mortality in Finland during two 10-year periods - 1985 to 1994 and 1995 to 2004 - analysing university and central hospital districts separately, as paediatric intensive care is centralised in university hospitals. The study looked at the main causes of death in each hospital, and the mortality rates were adjusted to demonstrate how many children were at risk of dying.
RESULTS: Postneonatal childhood mortality decreased during the study period in university and central hospital districts. We found no significant difference in mortality rates between university hospital districts, but regional differences were notable in central hospital districts, partly because of historical differences in mortality. Accidents were the most common cause of death, with substantial regional differences.
CONCLUSION: Regional postneonatal childhood mortality differed across central hospital districts, and this should be taken into account in the forthcoming restructuring of the Finnish healthcare system. Special attention is needed to prevent accidental deaths, both nationally and locally. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.