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A prospective cohort study comparing hospital admission for gastro-enteritis with home management
F Small1, F Alderdice, C McCusker
1Department of Child Health, The Queen's University of Belfast, UK.
Insights
Children with gastroenteritis admitted to hospital showed no significant difference in outcomes compared to those managed at home. However, parents of acutely ill children often seek reassurance and follow-up care, impacting healthcare services.
Area of Science:
- Pediatric Emergency Medicine
- Gastroenterology
- Child Psychology
Background:
- Gastroenteritis is a common pediatric illness requiring emergency department visits.
- Decisions regarding hospital admission versus home management for pediatric gastroenteritis are critical.
- Understanding the comparative outcomes of admitted versus discharged children is essential for optimizing care.
Purpose of the Study:
- To compare physical and psychological outcomes in children with gastroenteritis admitted to the hospital versus those discharged home.
- To assess the utilization of further healthcare services in both groups post-episode.
- To evaluate parental perceptions and family factors influencing management decisions.
Main Methods:
- Prospective cohort study of 116 children aged 1-6 years presenting with gastroenteritis.
- Comparison of admitted children with a matched group of children discharged home.
- Follow-up at 1 week and 1 month to assess clinical, psychological, and family outcomes.
Main Results:
- No significant differences in clinical outcomes or psychosocial factors between admitted and discharged groups.
- Admitted children experienced temporary increased separation anxiety at 1 week, which resolved by 1 month.
- Admitted children underwent more investigations, despite similar parental satisfaction and subsequent healthcare seeking behavior in both groups.
Conclusions:
- Hospital admission for pediatric gastroenteritis does not confer statistically significant advantages in clinical or psychosocial outcomes compared to home management for similar illness severity.
- Parents of acutely ill children, regardless of admission status, often seek reassurance and follow-up, highlighting service and resource implications.
- The study underscores the need for effective communication and support for parents managing children with gastroenteritis at home.
Objectives:
To compare physical and psychological outcomes in children presenting at Accident and Emergency Departments (A&E), diagnosed with gastro-enteritis and admitted to hospital with those of a similar age, sex and severity of illness discharged home. The physical and psychological well-being of children in these two groups, in the month after the episode, were compared as was further use of health care services.
Design:
A prospective cohort study.
Methods:
A comparison of 116 children aged 1-6 years with gastro-enteritis, presenting at A&E over a 6 months period. Admitted children were compared with children discharged, of a similar age, sex and illness severity (triage score) with follow-up at 1 week and 1 month. Clinical history, psychosocial factors, investigations and outcomes were recorded at presentation and physical, psychological and family outcomes at 1 week and 1 month.
Results:
Of 116 children, 112 (97%) completed the study (56 in each group). No differences were detected in psychosocial factors, socio-economic status, family factors, time of arrival at A&E or waiting times. Parental perception of illness was greater in the admitted group (P < 0.005), but was recorded after the decision on admission was made. At 1 week follow-up admitted children had increased separation anxiety compared with children who were discharged (P < 0.05), but this difference disappeared at 1 month. Clinical outcomes were the same for both groups, although admitted children had more investigations (91% vs. 39%). Parents were equally satisfied with their child's treatment, but one-third of children in both groups sought further consultation with a health professional in the following week.
Conclusions:
There is no statistically significant difference in socio-demographic data, time of arrival at A&E, waiting times, clinical and psychosocial outcomes in children with acute gastro-enteritis admitted to hospital compared with a group of children of similar age, gender and severity of illness managed at home. However, parents seek reassurance and follow-up of acutely ill children, even if the child is admitted to hospital, which has service and resource implications.
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