Abstract
BackgroundAdvances in healthcare have improved the survival of children with neurological disabilities (ND). Studies in the US have shown that children with ND use a substantial proportion of resources in children’s hospitals, however, little research has been conducted in the UK. We aimed to test the hypothesis that children with neurological disabilities use more inpatient resources than children without neurological disabilities, and to quantify any significant differences in resource use.MethodsA retrospective observational study was conducted, looking at the number of hospital admissions, total inpatient days and the reason for admissions for paediatric inpatients from January 1st to March 31st 2015. Inpatients were assigned into one of three groups: children without ND, children with one ND, and children with more than one ND.ResultsThe sample population included 942 inpatients (mean age 6y 6mo). Children with at least one ND accounted for 15.3% of the inpatients, 17.7% of total hospital inpatient admission episodes, and 27.8% of the total inpatients days. Neurological disability had a statistically significant effect on total hospital admissions (p < 0.001). Neurological disability also had a statistically significant effect on total inpatient days (p < 0.001). Neurological disability increased the length of inpatient stay across medicine, specialties, and surgery.ConclusionsChildren with ND had more frequent hospital admission episode and longer inpatient stays. We identified a smaller group within this population, with arguably more complex neurological disabilities, children with more than one ND. This group had the highest number of admissions and longest inpatient stays. More frequent hospital admissions and longer inpatient stays may place children with ND at greater risk of the adverse effects of hospitalisations. We recommend further investigations looking at each the effects of the different categories of ND on inpatient resource use, and repeat of this study at a national level and over a longer period of time.
Highlights
Advances in healthcare have improved the survival of children with neurological disabilities (ND)
This paper aims to test the hypothesis that children with ND use more inpatient resources, looking at the number of hospital admissions and length of inpatient stay
The sample hospital population consisted of 942 inpatients with at least one admission episode that included one day between January 1st and March 31st 2015
Summary
Advances in healthcare have improved the survival of children with neurological disabilities (ND). Stud‐ ies in the US have shown that children with ND use a substantial proportion of resources in children’s hospitals, how‐ ever, little research has been conducted in the UK. Studies in the US have shown that children with complex chronic conditions, of which includes children with ND, use a substantial proportion. A recurring theme in the available literature is the presence of a subset within the disabled population that accounts for a large proportion of healthcare resources [3, 4]. Some studies have equated a large amount of resource use by a small proportion of the hospital population, as being representative of. In the UK, there is a general perception among healthcare professionals that children with ND use a disproportionate amount of inpatient resources. There is little research looking at children with ND as a population group
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