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Recent trends in hospital use by children in England
1Paediatric Department, Pinderfields Hospital, Wakefield WF1 4DG, UK. mfrod@easynet.co.uk
Insights
Hospital statistics in England overestimate children's ward use by including "well babies." Accurate reporting requires separating neonatal care and well newborns from paediatric admissions for better resource planning.
Area of Science:
- Pediatric healthcare utilization
- Hospital statistics analysis
- Neonatal care reporting
Background:
- Routine hospital statistics in England inaccurately inflate children's ward usage.
- Data includes healthy newborn infants (
Purpose of the Study:
- To analyze trends in children's ward utilization.
- To exclude data on newborn infants from the analysis.
- To provide accurate pediatric admission statistics.
Main Methods:
- Reviewed routine and published data from the Department of Health.
- Stratified data by age to differentiate between "well babies" and those requiring neonatal specialist care.
- Separated admissions to children's wards into surgical and pediatric categories.
Main Results:
- "Well babies" constituted nearly half of the reported admissions to children's wards.
- Excluding these, pediatric admissions represented 9.9% of children under 5 annually, with 2.5% for surgical care.
- Between 1989-1997, pediatric admissions increased by 19%, surgical admissions decreased by 25%, and neonatal care rose despite falling birth rates.
Conclusions:
- Establish distinct reporting categories for pediatric and neonatal unit episodes.
- Improve identification and separation of "well babies" in hospital statistics.
- Separate pediatric data from neonatal units when planning or monitoring inpatient facilities, including surgical episodes.
Background:
Routine hospital statistics for England appear to overestimate use of children's wards and include numbers of well newborn babies staying with their mothers after delivery ("well babies").
Aim:
To review trends in use of children's wards excluding data on newborn babies.
Methods:
We reviewed routine, published, and age stratified data requested from the Department of Health to identify separately "well babies" and babies receiving neonatal specialist care from admissions (surgical and paediatric) to children's wards.
Results:
Routine reports for paediatric activity contain large numbers of "well babies", (almost half the total) as well as babies receiving specialist neonatal care. After excluding these, paediatric admissions represent 9.9% of the child population aged under 5 years each year (an additional 2.5% are admitted for surgical care). Between 1989 and 1997 paediatric admissions rose by 19% and surgical admissions fell by 25% with a plateau reached in overall child admissions. There are now fewer beds in which children stay for a shorter time and there is more day case surgery. Neonatal specialist care work has risen despite a fall in births.
Conclusion:
Categories should be established for reporting paediatric episodes on children's wards separately from those on neonatal units, with better identification of "well babies". When monitoring use of children's inpatient facilities or planning new units, care must be taken to separate paediatric data on neonatal units from work on children's wards. Children's surgical episodes should also be taken into account.