Changing characteristics of hospital admissions but not the children admitted-a whole population study between 2000 and 2013

TY - JOUR

T1 - Changing characteristics of hospital admissions but not the children admitted-a whole population study between 2000 and 2013

AU - Al-Mahtot, Maryam

AU - Barwise-Munro, Rebecca

AU - Wilson, Philip

AU - Turner, Steve

PY - 2018/3/1

Y1 - 2018/3/1

N2 - There are increasing numbers of emergency medical paediatric admissions. Our hypothesis was that characteristics of children and details of their emergency admissions are also changing over time. Details of emergency admissions in Scotland 2000-2013 were analysed. There were 574,403 emergency admissions, median age 2.3 years. The age distribution, proportion of boys and socioeconomic status of children admitted were essentially unchanged. Emergency admissions rose by 49% from 36/1000 children per annum to 54/1000 between 2000 and 2013. Emergency admissions that were discharged on the same day rose by 186% from 8.6/1000 to 24.6/1000. The mean duration of emergency admission fell from 1.7 to 1.0 days. The odds for an emergency admission with upper respiratory infection, "viral infection", tonsillitis, bronchiolitis and lower respiratory tract infection all rose. In contrast the odds for an emergency admission with asthma and gastroenteritis fell.CONCLUSIONS: The demographics of children with emergency admissions have not changed substantially but characteristics of admissions have changed considerably, in particular admissions which are short stay and due to respiratory infection are much more common. The fall in the absolute number of children with some acute medical diagnoses suggests that the rise in admissions is not necessarily inexorable. What is Known: • Emergency admission prevalence is rising in many countries across Europe. What is New: • Our paper is the first to comprehensively analyse emergency medical paediatric admissions by exploring how characteristics of admissions and the children admitted have changed over time for a whole population. • The "take home message" is that whilst characteristics of emergency admissions have changed (e.g. number, duration of stay, readmissions, diagnoses), the characteristics of the children have not changed.

AB - There are increasing numbers of emergency medical paediatric admissions. Our hypothesis was that characteristics of children and details of their emergency admissions are also changing over time. Details of emergency admissions in Scotland 2000-2013 were analysed. There were 574,403 emergency admissions, median age 2.3 years. The age distribution, proportion of boys and socioeconomic status of children admitted were essentially unchanged. Emergency admissions rose by 49% from 36/1000 children per annum to 54/1000 between 2000 and 2013. Emergency admissions that were discharged on the same day rose by 186% from 8.6/1000 to 24.6/1000. The mean duration of emergency admission fell from 1.7 to 1.0 days. The odds for an emergency admission with upper respiratory infection, "viral infection", tonsillitis, bronchiolitis and lower respiratory tract infection all rose. In contrast the odds for an emergency admission with asthma and gastroenteritis fell.CONCLUSIONS: The demographics of children with emergency admissions have not changed substantially but characteristics of admissions have changed considerably, in particular admissions which are short stay and due to respiratory infection are much more common. The fall in the absolute number of children with some acute medical diagnoses suggests that the rise in admissions is not necessarily inexorable. What is Known: • Emergency admission prevalence is rising in many countries across Europe. What is New: • Our paper is the first to comprehensively analyse emergency medical paediatric admissions by exploring how characteristics of admissions and the children admitted have changed over time for a whole population. • The "take home message" is that whilst characteristics of emergency admissions have changed (e.g. number, duration of stay, readmissions, diagnoses), the characteristics of the children have not changed.

KW - Adolescent

KW - Age Distribution

KW - Asthma/epidemiology

KW - Child

KW - Child, Preschool

KW - Emergencies

KW - Female

KW - Gastroenteritis/epidemiology

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Logistic Models

KW - Male

KW - Patient Admission/statistics & numerical data

KW - Respiratory Tract Infections/epidemiology

KW - Scotland/epidemiology

KW - Sex Distribution

U2 - 10.1007/s00431-017-3064-z

DO - 10.1007/s00431-017-3064-z

M3 - Journal article

C2 - 29260375

SN - 0340-6199

VL - 177

SP - 381

EP - 388

JO - European Journal of Pediatrics

JF - European Journal of Pediatrics

IS - 3

ER -