Related Experiment Videos
Conditions accounting for substantial time spent in hospital in children aged 1-14 years
J Henderson1, M J Goldacre, J M Fairweather
1Unit of Clinical Epidemiology, University of Oxford.
Insights
This study analyzed pediatric hospital stays, finding that while most conditions saw shorter durations, certain serious illnesses like leukemia and metabolic disorders required longer care. Asthma admissions and bed days increased significantly.
Area of Science:
- Pediatric Healthcare Research
- Hospital Epidemiology
- Clinical Informatics
Background:
- Understanding factors contributing to prolonged pediatric hospital stays is crucial for resource allocation and care improvement.
- Historical data analysis can reveal trends in childhood illness burden and healthcare utilization.
Purpose of the Study:
- To identify clinical conditions associated with substantial time spent in hospital by children aged 1-14 years.
- To analyze trends in pediatric inpatient care duration and resource utilization over time.
Main Methods:
- Analysis of linked hospital inpatient records from six southern England districts (1975, 1979, 1984).
- Calculation of total time spent in hospital by summing lengths of stay for each child annually.
- Identification of conditions based on median time per child, number of children with stays ≥5 days, and total bed days used.
Main Results:
- Conditions with long median stays included femur fractures, leukemia, malignant neoplasms, and metabolic disorders.
- Congenital anomalies, asthma, and appendicitis accounted for a large number of children with stays ≥5 days.
- Congenital anomalies, tonsil/adenoid hypertrophy, asthma, otitis media, appendicitis, and head injury used the most bed days.
Conclusions:
- Median hospital stay per child declined for most conditions, but increased for leukemia, neoplasms, and metabolic disorders.
- Admission rates for stays ≥5 days decreased for most conditions, except asthma, which rose.
- Bed days increased for asthma and otitis media, while declining for other common pediatric conditions.
Abstract:
To identify the clinical conditions associated with substantial time spent in hospital by children aged 1-14 years, records of children admitted to hospital in 1975, 1979, and 1984 were studied. Analysis was by linkage of abstracts of routine records of hospital inpatient care in six districts in southern England covered by the Oxford record linkage study. The total time spend in hospital in the acute specialties each year was calculated by summing the lengths of stay of all episodes of care for each child in each year. First, admissions with long median times in hospital per child admitted were identified. These included, notably, fracture of femur and, in the later years, leukaemia, other malignant neoplasms, and congenital disorders of metabolism. Second conditions were identified which accounted for large numbers of children with lengths of stay of five days or more. These included, in particular, congenital anomalies, asthma, and appendicitis. Third, conditions were identified which accounted for the largest numbers of bed days used. These included congenital anomalies, hypertrophy of tonsils and adenoids, asthma, otitis media, appendicitis, and head injury. Median time spent in hospital per child admitted declined for most conditions but increased for leukaemia, other malignant neoplasms, and congenital disorders of metabolism. Admission rates for children who spent five days or more in hospital each year declined for all common conditions except asthma which increased. Total numbers of beds used increased for asthma and otitis media but declined for all other common conditions.