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Rising Unscheduled Healthcare Utilisation of Children and Young People: How Does the Rise Vary Across Deprivation
Josip Plascevic1, Joseph Ward2, Russell M Viner2
1Child Health, University of Aberdeen, Aberdeen, UK.
Insights
Urgent healthcare use by children and young people (CYP) increased across the UK. Deprivation consistently linked to higher use, but trends varied, narrowing inequality in England while widening it in Scotland.
Area of Science:
- Public Health
- Healthcare Services Research
- Pediatric Health
Background:
- Urgent healthcare utilization among children and young people (CYP) presents a significant public health concern.
- Variations in healthcare access and outcomes based on socioeconomic factors are well-documented.
- Understanding trends in urgent care for CYP is crucial for equitable healthcare planning.
Purpose of the Study:
- To analyze trends in urgent healthcare use among CYP across England, Scotland, and Wales from 2007 to 2017.
- To investigate the association between socioeconomic deprivation and urgent healthcare utilization in CYP.
- To identify national differences in these trends and their implications for health inequalities.
Main Methods:
- Retrospective population-based analysis of urgent hospital admissions, short stay urgent admissions (SSUA), and Emergency Department (ED) attendances.
- Data stratified by age groups and Index of Multiple Deprivation (IMD) quintiles.
- Linear mixed-effects models employed to assess temporal trends and deprivation-related variations.
Main Results:
- Urgent admissions, SSUA, and ED attendances increased across all deprivation quintiles in all UK nations studied.
- Higher levels of deprivation were consistently associated with increased urgent healthcare utilization among CYP.
- England showed a narrowing of health inequality with slower increases in urgent care for most deprived CYP, while Scotland exhibited widening inequality.
Conclusions:
- Significant variations exist in the trends of urgent healthcare use for CYP across UK nations.
- Socioeconomic deprivation is a key factor influencing urgent healthcare utilization, with differing impacts on health inequality between England and Scotland.
- Findings can inform targeted interventions and policy adjustments to optimize NHS pathways and reduce disparities in CYP urgent care.
Abstract:
This retrospective population-based analysis assessed variations in urgent healthcare use by children and young people (CYP) across UK nations (England, Scotland and Wales) between 2007 and 2017. The study focused on urgent hospital admissions, short stay urgent admissions (SSUA) and Emergency Department (ED) attendances among CYP aged <25 years, stratified by age groups and Index of Multiple Deprivation (IMD) quintile groups. A linear mixed model was used to assess trends in healthcare activity over time and across deprivation quintiles. Urgent admissions, SSUA and ED attendances increased across all deprivation quintiles in all studied nations. Increasing deprivation was consistently associated with higher urgent healthcare utilisation. In England, the rise in urgent admissions and SSUA for CYP was slower for CYP from the quintile of greatest deprivation compared those from the least deprived quintile (respective mean differences 0.69/1000/y [95% CI 0.53, 0.85] and 0.25/1000/y [0.07, 0.42]), leading to a narrowing in health inequality. Conversely, in Scotland, urgent admissions and SSUA increased more rapidly for CYP from all deprivation quintiles, widening health inequality. Understanding the differences we describe here could inform changes to NHS pathways of care across the UK which slow the rise in urgent healthcare use for CYP.
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