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Hospital admissions before the age of 2 years in Western Australia
A W Read1, J Gibbins, F J Stanley
1Western Australian Research Institute for Child Health, Children's Hospital Medical Centre, Perth.
Insights
Aboriginal children in Western Australia experienced significantly higher rates of hospital admissions and longer stays before age two compared to non-Aboriginal children. This highlights disparities in child health and healthcare access.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Childhood morbidity significantly impacts long-term health outcomes.
- Understanding hospital admission patterns is crucial for public health interventions.
- Disparities in healthcare access and outcomes exist among different populations.
Purpose of the Study:
- To investigate inpatient hospital morbidity in the first two years of life for Aboriginal and non-Aboriginal children born in Western Australia in 1986.
- To compare the rates, frequency, and reasons for hospital admissions between these two groups.
- To identify key disease categories contributing to childhood hospitalizations.
Main Methods:
- Utilized a linked data file of birth records and hospital admissions for all children born in Western Australia in 1986.
- Analyzed data for non-Aboriginal and Aboriginal children separately.
- Calculated admission rates, mean hospital days, admission frequency, and disease category distribution.
Main Results:
- Aboriginal children had substantially higher hospital admission rates (2797/1000 live births) and longer mean hospital stays (26.5 days) compared to non-Aboriginal children (526/1000 live births, 7.4 days).
- Aboriginal children were more likely to have multiple admissions (36% admitted at least three times vs. 4% for non-Aboriginal) and admissions across multiple disease categories (16% in at least four vs. 1% for non-Aboriginal).
- Gastrointestinal, respiratory diseases, and social admissions were the leading causes for hospitalization in both groups, with higher prevalence among Aboriginal children.
Conclusions:
- Significant disparities in hospital morbidity exist between Aboriginal and non-Aboriginal children in Western Australia before the age of two.
- The findings underscore the need for targeted public health strategies to address the higher burden of disease and healthcare utilization among Aboriginal infants.
- Relating individual hospital admissions to the total population and using clinically relevant disease classifications are vital for effective descriptive and analytical research in child health.
Abstract:
A linked data file of birth records and hospital admissions was used to investigate inpatient hospital morbidity before 2 years of age for all non-Aboriginal and Aboriginal children born in Western Australia in 1986. Of the non-Aboriginal children, 31.8% were admitted to hospital at least once before the age of 2 years, with an overall admission rate of 526/1000 live births; the corresponding figures for Aboriginal children were 68.7% and 2797. The mean number of days in hospital for each non-Aboriginal child admitted was 7.4, and 26.5 for Aboriginal children. Of the total cohort, 21% of non-Aboriginal and 20% of Aboriginal children were admitted only once, and 4% of non-Aboriginal and 36% of Aboriginal children were admitted at least three times; 23% of non-Aboriginal and 24% of Aboriginal children were admitted for only one major disease category, and 1% of non-Aboriginal and 16% of Aboriginal children were in at least four categories. The highest admission rates and highest percentages of the cohort admitted were for gastrointestinal and respiratory diseases and social admissions. These results illustrate the importance for both descriptive and analytical research of relating admissions to hospital for the total population to the individual child, and of using clinically relevant disease classifications.