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Diagnostic and socio-demographic changes in multiple hospital admission in children under two over a five-year period
N J Spencer1, M A Lewis, S Logan
1School of Postgraduate Medical Education, University of Warwick, Coventry.
Insights
Multiple hospital admissions in young children increased between 1980 and 1985. This trend disproportionately affected low-birthweight infants and those from deprived areas, with earlier first admissions noted.
Area of Science:
- Pediatrics
- Public Health
- Healthcare Research
Background:
- Multiple hospital admissions before age two represent a significant healthcare burden.
- Understanding trends in early childhood admissions is crucial for resource allocation and preventative strategies.
Purpose of the Study:
- To analyze diagnostic and socio-demographic changes in children with multiple hospital admissions (≥3) before age two.
- To compare trends between two birth cohorts (1980 and 1985) to identify shifts in admission patterns.
Main Methods:
- Retrospective analysis of hospital admission data for two distinct birth cohorts (1980 and 1985).
- Comparison of diagnostic groups and socio-demographic factors (birth weight, maternal age, area deprivation) between multiple admission and control groups.
Main Results:
- Overall increase in multiple admissions between 1980 and 1985, evenly distributed across diagnostic groups.
- A notable trend towards earlier age of first admission observed.
- Low-birthweight infants, infants of young mothers, and those from deprived areas were consistently overrepresented in multiple admission groups.
- Significant increase in the proportion of low-birthweight infants within the multiple admission group from 1980 to 1985.
Conclusions:
- The rise in early childhood hospital admissions between 1980 and 1985 is partly explained by an increase in low-birthweight infants.
- Socio-demographic factors remain critical predictors of multiple hospital admissions in early childhood.
- Further research is needed to understand the drivers of the unexplained increase in early childhood admissions.
Abstract:
Diagnostic and socio-demographic changes for children experiencing multiple hospital admissions (three or more) before the age of two years in two whole-year birth cohorts five years apart-1980 and 1985-are reported. The increase in multiple admissions between 1980 and 1985 was distributed evenly throughout the diagnostic groups. Although a disproportionate increase in admissions per child for asthma was noted, the results suggest that the increase accounts for only a small proportion of the total increase. A marked trend to earlier age of first admission is reported. Low-birthweight infants, infants of young mothers and infants from deprived areas of the city are overrepresented in the multiple admission groups in both cohorts. There was a marked increase in the proportion of low-birthweight infants in the multiple admissions group between 1980 and 1985 compared with a decrease in the percentage of low-birthweight infants in the control group over the same period. The study results are discussed with particular reference to the unexplained increase in early childhood admissions.