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Hospital admissions and school absences of primary school children with and without neurodisability
Laura Gimeno1,2, Ania Zylbersztejn1,3, Ayana Cant1
1Great Ormond Street Institute of Child Health, University College London, London, UK.
Insights
Children with neurodisability experience significantly higher hospital admission and school absence rates during primary school. Integrated health and education support is crucial for their educational participation.
Area of Science:
- Pediatric Health
- Neurodevelopmental Disorders
- Educational Psychology
Background:
- Children with neurodisability often require integrated health and education services.
- Understanding hospitalization and school absence patterns is key to providing effective support.
- Previous research highlights disparities but lacks comprehensive data across primary school.
Purpose of the Study:
- To compare hospitalization and school absence rates in primary school children with and without neurodisability.
- To inform integrated support strategies between education and health services.
- To identify specific neurodisability subgroups with the highest rates of admission and absence.
Main Methods:
- Linked administrative data cohort study of 2,351,589 children born in England (2003-2008).
- Follow-up from Reception class (age 4/5) to end of primary school (age 10/11).
- Identification of children with hospital-recorded neurodisability before school entry; analysis of hospital admissions and school absence rates.
Main Results:
- Children with neurodisability (2.2% of cohort) had substantially higher planned (29.0 vs 4.3 per 100 person-years) and unplanned (16.6 vs 3.7 per 100 person-years) hospital admission rates.
- Children with neurodisability missed more school days (6.5% vs 4.2% of total school days).
- Cerebral palsy subgroup showed the highest admission and absence rates; high-risk perinatal conditions subgroup showed the lowest.
Conclusions:
- Children with neurodisability face significantly elevated hospital admission and school absence throughout primary school.
- A coordinated approach between healthcare and educational institutions is essential.
- Improved collaboration can enhance educational participation for children with neurodisability.
Aim:
To inform integrated support by education and health services by comparing hospitalization and school absence rates during primary school in children with and without neurodisability.
Method:
In this linked administrative data cohort study, we followed 2 351 589 children born in England between 2003 and 2008 from enrolment in Reception class (age 4/5 years) to the end of primary school (age 10/11 years) using linked hospital and school records, identifying those with hospital-recorded neurodisability before starting school. We described rates of hospital admissions (per 100 person-years at risk) and school absences (percentage of total school days).
Results:
Compared with those without neurodisability, the 2.2% of children with neurodisability had higher rates of planned and unplanned hospital admission during primary school (29.0 and 16.6 per 100 person-years at risk respectively, vs 4.3 and 3.7 per 100 person-years at risk) and missed more school days (6.5% vs 4.2%). Among subgroups of children with neurodisability, rates of admission and absence were consistently highest for those with cerebral palsy and lowest for those with high-risk perinatal conditions.
Interpretation:
Children with neurodisability have far higher rates of hospital admission and school absence compared with those without neurodisability throughout primary school. A joined-up approach is needed between hospital and school to support children with neurodisability to participate in education.
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