Assessing the appropriateness of paediatric hospital admissions in the United Kingdom

Esmail, Aneez; Quayle, Julie Ann; Roberts, Chris

doi:10.1093/pubmed/22.2.231

Cited by 18 publications

(18 citation statements)

References 32 publications

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“…Also, in our study sex did not have any effect on the rate of inappropriate admission, contrary to other studies [8,9,10]. This can be explained by the fact that almost overall equal numbers of both sexes were referred to the emergency room and this can be interpreted as equal care given by parents and caregivers to both boys and girls in Kuwait.…”

Section: Discussioncontrasting

confidence: 99%

“…There was no difference in the rate of inappropriate admission at different times of the day, contrary to the findings of other studies [9,10]. In the study by Bianco et al [9], inappropriate admission occurred more during the day and was interpreted by use of the hospital as a primary care facility because it was easier to attend and find a pediatrician during the day [9].…”

Section: Discussionmentioning

confidence: 76%

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Appropriateness of Pediatric Hospitalization in a General Hospital in Kuwait

Shafik¹,

Seoudi²,

Raway³

et al. 2012

Med Princ Pract

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Objectives: To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. Subjects and Methods: A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Results: Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. Conclusion: The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child’s condition.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 76%

Appropriateness of Pediatric Hospitalization in a General Hospital in Kuwait

Shafik¹,

Seoudi²,

Raway³

et al. 2012

Med Princ Pract

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“…It is not possible to infer whether a high admission rate represents a high need for admission or variation in medical practice. 30,31 Admission rates may be higher from localities with easy access to hospital or vary with clinical and parental thresholds for admission and organization of out of hours primary care services. 32 The rate of emergency hospital admission for respiratory infections in children has increased over the past decade in the United Kingdom.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Gestational Age, Birth Weight, and Risk of Respiratory Hospital Admission in Childhood

et al. 2013

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OBJECTIVE: To investigate the risk of emergency respiratory hospital admission during childhood associated with gestational age at birth and growth restriction in utero. METHODS: The study included a total population electronic birth cohort with anonymized record-linkage of multiple health and administrative data sets. Participants were 318 613 children born in Wales, United Kingdom, between May 1, 1998, and December 31, 2008. The main outcome measure was emergency respiratory hospital admissions. RESULTS: The rate of admission in the first year of life ranged from 41.5 per 100 child-years for infants born before 33 weeks’ gestation to 9.8 per 100 child-years for infants born at 40 to 42 weeks’ gestation. The risk of any emergency respiratory admission up to age 5 years increased as gestational age decreased to <40 weeks. Even at 39 weeks’ gestation, there was an increased risk of emergency hospital admissions for respiratory conditions compared with infants born at 40 to 42 weeks (adjusted hazard ratio 1.10; 95% confidence interval 1.08–1.13). Small for gestational age (<10th centile for gestation and gender-specific birth weight) was independently associated with an increased risk of any emergency respiratory admission to hospital (adjusted hazard ratio 1.07; 95% confidence interval 1.04–1.10). CONCLUSIONS: The risk of emergency respiratory admission up to age 5 years decreased with each successive week in gestation up to 40 to 42 weeks. Although the magnitude of increased risk associated with moderate and late preterm births is small, the number of infants affected is large and therefore presents a significant impact on health care services.

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“…Numerous conditions that were previously fatal are now treatable 1 . Children today are born healthier but more and more are also being admitted to hospital than ever before 2 . In the context of intensive care management, outcome analysis coupled with demographic status and clinical details have become a challenge for the modern day intensivist 3 .…”

Section: Introductionmentioning

confidence: 99%

Prospective study of ventilated patients in the paediatric medical intensive care unit of Lady Ridgeway Hospital

Thadchanamoorthy

Silva

Sarathchandra

et al. 2012

Sri Lanka J Child Health

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Objective: To determine the characteristics and outcome of ventilated patients in the paediatric medical intensive care unit (PICU) of Lady Ridgeway Hospital for Children (LRH), Colombo. Design: Prospective descriptive study Method:The study population consisted of all ventilated paediatric patients admitted to PICU, LRH from 1 st March to 31 st August, 2009. The factors studied included demographic profile (age, sex, residence, transfer), length of stay on ventilator, indication for ventilation, details of organ dysfunction and the final outcome.Results: There were 152 patients ventilated over the study period of six months. Seventy three were under one year of age. Male to female ratio was 1.17:1. A significant proportion (n=105) were from the Western province. Eighty five patients were transferred from medical wards of LRH. Median duration of ventilation was six days (IRQ 4-10). Indications for ventilation included respiratory problems (85), neurological disorders (13), cardiac causes (5), hepatic problem (1) and miscellaneous diseases (48) including 32 from dengue syndromes. There were 42 deaths among ventilated patients giving an overall mortality rate of 27.6%. Multiorgan dysfunction syndrome (MODS) on admission accounted for 81% of the deaths. Bronchopneumonia (16) and dengue haemorrhagic fever (12) were the main underlying causes of death. Thirty two (21%) had anaemia while in the PICU, 15 of them having anaemia on admission. Nosocomial infection was present in 17 (11%) patients. Children transferred from other provinces had a higher risk of death than those from the Western province (OR=1.5, 95% CI: 0.7 -3.3 Conclusions: MODS on admission accounted for 81% of the deaths. Bronchopneumonia and dengue haemorrhagic fever were the main underlying causes of death. Children transferred from other provinces had a higher risk of death compared to those from the Western province

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Assessing the appropriateness of paediatric hospital admissions in the United Kingdom

Abstract: The low level of inappropriate admissions may be a reflection of well-developed primary care services in the United Kingdom. Alternatives to hospital admission for the assessment of minor self-limiting illness in young children may have a role in reducing inappropriate admissions.

Cited by 18 publications

References 32 publications

Appropriateness of Pediatric Hospitalization in a General Hospital in Kuwait

Appropriateness of Pediatric Hospitalization in a General Hospital in Kuwait

Gestational Age, Birth Weight, and Risk of Respiratory Hospital Admission in Childhood

Prospective study of ventilated patients in the paediatric medical intensive care unit of Lady Ridgeway Hospital

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