4, 19, 25, 26 and 27 In this study, the mean hospital length of stay during ten years was reduced by only 20% (0.85 days), with a mean of 4 days among children younger than 1 year and 3.4 days in those aged 1 to 4 years. The Midwest and South had the highest

rates of annual decrease, a fact that needs further investigation to AZD5363 cost better understand such behavior. Associated with a modest reduction in hospital length of stay, there was a small reduction in mean hospitalization value (adjusted for inflation during the period), and it was assumed that investments targeted to reduce the length of hospitalization may represent a reduction in the health system burden attributed to diarrheal disease. In Brazil, in 2010, approximately R$ 9.8 million were spent on hospital admissions of children younger

than 1 year with diarrhea, and R$ 23.5 million for those aged between 1 and 4 years;8 these resources could have been invested in new therapeutic recommendations for the management of this pathology. It is worth mentioning that the HAA system of hospitalization control is based on a table of costs selleck kinase inhibitor per procedure, not necessarily associated with the actual costs of the hospitalization;28 therefore, these values may be underestimated. Research priorities are being defined to reduce the overall morbimortality of childhood diarrhea by 2015; the main areas are targeted

for public health and epidemiological policies in order to understand the barriers to the implementation and to optimize the available programs and interventions.29 It appears that strategies aimed at reducing the number of hospitalizations and length of hospital stay, with consequent reduction in cost and risk to the patient, are appropriate in the management of diarrheal disease in Brazil. The levels of mortality rates in children from diarrhea were found to be lower and slowly decreasing over the study period. Hospitalization rates remained stable, and there was a slight decrease in hospital length Rho of stay and hospital costs during disease management. There were regional differences for all indicators, except for the mean hospital stay. Clear and socially regulated public policies aiming primarily at reducing social differences; enabling collective sanitary measures; structuring health services; training human resources; and encouraging and financing research in local health diagnosis, information solutions, prevention, and treatment must be strategically coordinated so they can effectively extend the scope and resolution of what has been achieved when addressing this specific but crucial health situation. The authors declare no conflicts of interest.