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Hospital care of children with a cleft in England
Kate J Fitzsimons1, Lynn P Copley, Scott A Deacon
1Clinical Effectiveness Unit, Royal College of Surgeons of England, , London, UK.
Insights
Hospital admissions for children with cleft lip and/or palate in England varied by cleft type and additional anomalies. Cleft-specific care, however, remained consistent regardless of other congenital conditions.
Area of Science:
- Pediatric Surgery
- Public Health
- Congenital Anomalies
Background:
- Cleft lip and/or palate are common congenital conditions requiring significant healthcare resources.
- Understanding hospital admission patterns is crucial for resource allocation and patient management.
Purpose of the Study:
- To analyze hospital admissions in the first two years of life for children with cleft lip and/or palate in England.
- To investigate the impact of cleft type and additional congenital anomalies on hospital care burden.
Main Methods:
- Analysis of national administrative data on hospital admissions for children born between 1997 and 2008.
- Examination of the number of admissions and days spent in hospital, stratified by cleft type and presence of additional anomalies.
Main Results:
- Children with additional anomalies had significantly higher overall admissions (6.7) and hospital days (51.4) compared to those without (3.2 admissions, 13.2 days).
- Bilateral cleft lip and palate (BCLP) cases showed the highest admission rates and longest hospital stays within both groups.
- Despite overall differences, cleft-specific admissions and hospital days were similar between children with and without additional anomalies.
Conclusions:
- The overall burden of hospital care in early childhood for cleft conditions is influenced by cleft type and co-occurring anomalies.
- Targeted interventions and resource planning should consider these variations.
- Cleft-specific surgical care appears consistent, irrespective of additional congenital anomalies.
Objective:
To analyse hospital admissions in the first 2 years of life among children with cleft lip and/or palate in England.
Design:
Analysis of national administrative data of hospital admissions.
Setting:
National Health Service hospitals.
Patients:
Patients born alive between 1997 and 2008 who underwent surgical cleft repair.
Outcome Measures:
Number of admissions, including the birth episode, and days spent in hospital were examined. Children were analysed according to cleft type and whether or not they had additional congenital anomalies.
Results:
10 892 children were included. In their first 2 years, children without additional anomalies (n=8482) had on average 3.2 admissions and 13.2 days in hospital, which varied from 2.6 admissions and 9.2 days with cleft lip to 4.7 admissions and 19.7 days with bilateral cleft lip and palate (BCLP). Children with additional anomalies (n=2410) had on average 6.7 admissions and 51.4 days in hospital, which varied from 6.4 admissions and 48.5 days with cleft palate to 8.8 admissions and 67.5 days with BCLP. The mean number and duration of cleft-related admissions was similar in children without (1.6 admissions and 6.4 days) and in those with additional anomalies (1.5 admissions and 8.5 days). 35.2% of children without additional anomalies had at least one emergency admission, whereas the corresponding figure was 67.3% with additional anomalies.
Conclusions:
The burden of hospital care in the first 2 years of life varied according to cleft type and presence of additional anomalies. However, cleft-specific hospital care did not differ between children with and without additional anomalies.
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