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Time spent in hospital by children as a health care indicator: inter-district comparisons
J Henderson1, M J Goldacre, J Fairweather
1Department of Public Health and Primary Care, University of Oxford, Headington.
Insights
Hospitalization trends show an increase in short stays for children, while longer hospitalizations decreased. Differences in total hospital days between districts were minimal, suggesting potential for more day case care utilization.
Area of Science:
- Pediatric Healthcare
- Health Services Research
- Hospital Administration
Background:
- Global recommendations advocate for minimizing pediatric hospital admissions and stays.
- Effective home-based care and outpatient services are crucial for reducing hospital burden.
- Quantifying total time spent in hospital by children is essential for resource allocation.
Purpose of the Study:
- To calculate and compare the total annual hospital time spent by children across six districts in the Oxford Region.
- To analyze trends in pediatric hospitalization durations over time.
- To assess inter-district variations in hospital utilization and identify areas for improvement.
Main Methods:
- Utilized record linkage to compute total annual hospital days per child.
- Compared hospitalization statistics across six defined geographical districts.
- Analyzed trends in hospitalization rates based on duration (≤2 days vs. >2 days).
Main Results:
- Hospitalization rates for children with short stays (≤2 days/year) increased over the study period.
- Rates for children with longer stays (>2 days/year) showed a decline.
- Mean and median total hospital days varied slightly between districts, with differences less than one day per child annually.
- Inter-district variation in hospital utilization decreased over time.
- Significant variation in day case care utilization persisted among districts.
Conclusions:
- Pediatric hospitalization patterns are shifting towards shorter, more frequent admissions.
- While absolute differences in hospital stay duration between districts are small, variations in day case care suggest opportunities for optimizing resource use.
- Further implementation of day case procedures could enhance efficiency in pediatric care delivery.
Abstract:
It has been widely recommended that children should be admitted to hospital only if treatment cannot be provided at home, and that durations of hospital stay should be minimized. We have used record linkage to calculate a statistic which is not yet commonly available, the total time spent in hospital by children per year, and have compared this between six districts in the Oxford Region. Hospitalization rates for children who stayed a total of two days or less per year in hospital increased over time; rates for children who stayed more than two days declined. Mean and median total days spent in hospital varied between districts but, in absolute terms, the differences were small at less than one day's difference between districts per year per child admitted. Inter-district variation decreased over time, although the variation in use of day case care which remained suggests that some districts could still do more work in this fashion.