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Hospital admissions of school-age children with an intellectual disability: A population-based survey
Karen A Horridge1,2, Grace Bretnall1, Lorna K Fraser3,4
1Paediatric Disability Department, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.
Insights
Children with learning disabilities and safeguarding needs experience more hospital admissions and longer stays. Early identification is crucial for addressing their healthcare requirements effectively.
Area of Science:
- Pediatric Healthcare
- Developmental Disabilities
- Child Safeguarding
Background:
- Learning disabilities (intellectual developmental disorder) and safeguarding needs significantly impact children's health outcomes.
- Proactive identification of learning disabilities is integrated into clinical practice within the study population.
Purpose of the Study:
- To compare hospital admission profiles of school-aged children with and without identified learning disabilities and/or safeguarding needs.
- To analyze the impact of identified learning disabilities and safeguarding flags on hospital admission patterns.
Main Methods:
- Retrospective analysis of hospital admissions for school-aged children (April 2017-March 2019).
- Data collection included reasons for admission, duration, and presence of learning disability or safeguarding flags.
- Negative binomial regression modeling was used to assess the impact of flags on outcomes.
Main Results:
- 2.53% of the child population had a learning disability flag.
- Children with learning disability and/or safeguarding flags showed significantly increased hospital admission rates and length of stay compared to those without.
- 5.5% had a learning disability, 10.9% had safeguarding flags, and 1.1% had both.
Conclusions:
- Children with learning disabilities and/or safeguarding needs have higher hospital admission rates and longer hospital stays.
- Consistent identification of learning disabilities in childhood is essential to make their needs visible in routine data.
- Systematic data collection across educational, health, and social care is vital for addressing the needs of this vulnerable population.
Aim:
To describe the profiles of hospital admissions of school-age children identified with a learning disability (ICD-11 intellectual developmental disorder) and/or safeguarding needs compared to children without learning disability, in a population where proactive identification of learning disabilities in children is embedded in practice.
Method:
Data were collected about the reasons for and duration of hospital admissions of school-age children living in the study catchment area between April 2017 and March 2019; the presence (or absence) of learning disability and/or safeguarding flags in the medical record was also noted. The impact of the presence of flags on the outcomes was explored using negative binomial regression modelling.
Results:
Of 46 295 children in the local population, 1171 (2.53%) had a learning disability flag. The admissions of 4057 children were analysed (1956 females; age range 5-16 years, mean 10 years 6 months, SD 3 years 8 months). Of these, 221 out of 4057 (5.5%) had a learning disability, 443 out of 4057 (10.9%) had safeguarding flags, 43 out of 4057 (1.1%) had both, and 3436 out of 4057 (84.7%) had neither. There was a significantly increased incidence of hospital admissions and length of stay in children with either or both flags, compared to children with neither.
Interpretation:
Children with learning disabilities and/or safeguarding needs have higher rates of hospital admissions than children without. Robust identification of learning disabilities in childhood is required to make the needs of this group visible in routinely collected data as the first step towards needs being appropriately addressed.
What This Paper Adds:
Children with learning disabilities must be consistently identified in populations so that their needs are made visible. Information about these needs must be collected from educational, health, and social care sources and scrutinized systematically. Children with learning disabilities and safeguarding needs have an increased incidence of hospital admissions and length of stay.
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