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Tertiary paediatric hospital admissions in children and young people with cerebral palsy
E Meehan1,2, G L Freed3, S M Reid1,2
1Department of Paediatrics, University of Melbourne, Melbourne, Australia.
Insights
Children and young people with cerebral palsy (CP) experience frequent hospital admissions, particularly those with severe motor impairment or epilepsy. Respiratory and musculoskeletal conditions are common reasons for admission, highlighting needs for improved prevention and management.
Area of Science:
- Pediatric Health
- Neurology
- Public Health
Background:
- Previous studies on pediatric cerebral palsy (CP) hospital admissions lack data on CP severity and complexity.
- Understanding factors influencing CP hospital admission frequency and type is limited.
Purpose of the Study:
- To describe patterns of tertiary pediatric hospital service utilization in children and young people with CP.
- To analyze factors associated with hospital admissions in this population over a 5-year period.
Main Methods:
- Retrospective cohort analysis of routinely collected admission data.
- Inclusion of individuals born between 1993-2008 registered with the Victorian Cerebral Palsy Register (n=2183).
Main Results:
- Over 50% of the cohort had same-day or multi-day admissions between 2008-2012.
- Moderate-to-severe motor impairment and epilepsy diagnosis correlated with increased admissions and longer stays.
- Respiratory and musculoskeletal diseases were primary reasons for medical and surgical admissions, respectively.
Conclusions:
- Hospital admission reasons reflect comorbidities in pediatric CP.
- Study identifies priorities for prevention, early diagnosis, and management to reduce admissions and healthcare costs.
- Enhanced prevention strategies could decrease non-elective admissions and readmissions, optimizing resource use.
Background:
Many previous studies that have investigated hospital admissions in children and young people with cerebral palsy lack information on cerebral palsy severity and complexity. Consequently, little is known about factors associated with the frequency and type of hospital admissions in this population. This study used hospital admission data available for all children and young people known to a population-based cerebral palsy register to describe the patterns of use of tertiary paediatric hospital services over a 5-year period.
Methods:
This was a retrospective cohort analysis of routinely collected admission data from the two tertiary paediatric hospitals in the Australian state of Victoria. Data on admissions of individuals born between 1993 and 2008 registered on the Victorian Cerebral Palsy Register were analysed (n = 2183).
Results:
Between 2008 and 2012, 53% of the cohort (n = 1160) had at least one same-day admission, and 46% (n = 996) had one or more multi-day admissions. Those with a moderate to severe motor impairment and those with a co-diagnosis of epilepsy had more admissions, and for multi-day admissions, longer lengths of stay, P < 0.05. Across all severity levels, respiratory and musculoskeletal diseases were the most frequently reported reasons for medical and surgical admissions, respectively. All-cause readmission rates for urgent multi-day stays within 7, 30 and 365 days of an index admission were 10%, 23% and 63%, respectively.
Conclusions:
The reasons for hospital admissions reported here reflect the range of comorbidities experienced by children and young people with cerebral palsy. This study highlights priority areas for prevention, early diagnosis and medical management in this group. Improved primary and secondary prevention measures may decrease non-elective hospital admissions and readmissions in this group and reduce paediatric inpatient resource use and healthcare expenditure attributable to cerebral palsy.
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