Abstract
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.
Highlights
The rate of childhood emergency admissions to hospital with acute medical diagnoses in England rose by 28% between 1999 and 2010 [9]
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 prevalence of emergency admissions rose by 37% from 180/1000 in 2000 to 247/1000 in 2013 and similar magnitude % rises were seen in all age groups (Table 2 in supplement)
Summary
The rate of childhood emergency admissions to hospital with acute medical diagnoses in England rose by 28% between 1999 and 2010 [9]. Emergency admissions include those where a child has an unscheduled admission to a hospital ward, and does not include cases seen and discharged home after an emergency department attendance. In the UK, emergency admissions occur when a child is admitted to a hospital inpatient ward after having been referred to medical paediatric services by a doctor or specialist nurse working in either the community (general practice or the primary care out of hours service) or in the hospital emergency department. The emergence of short stay paediatric assessment units in the late 1990s may have reduced costs but may have led to increasing emergency admissions [4, 14]
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