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ADC Fetal and Neonatal Edition Letters and ADC Education and Practice Letters
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Electronic letters published:
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Recent trends in hospital use by children in England
- Sam Oddie (1 November 2001)
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Let's not forget adolescents when planning children's inpatient services
- Russell Viner (26 November 2001)
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Sam Oddie, Specialist Registrar Paediatrics James Cook Univeristy, Middlesborough
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s.j.oddie{at}ncl.ac.uk Sam Oddie
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Dear Editor, We congratulate MacFaul and Werneke[1] on showing that large numbers of well newborn infants artificially inflate the statistics of hospital admissions of children. We can provide data on admission to hospital in the first month of life. By examining all hospital databases within the Northern region we identified 1897 possible admissions to hospital of babies under the age of 29 days during the calendar year 1998. One auditor then reviewed the notes of 1716 (90%) of these babies and found that only 907 (53%) met our definition for true admissions suggesting that the true total number of admissions was 1005. This definition required that babies be admitted to a paediatric or neonatal unit at least overnight after initial discharge home. Subsequent readmissions, day unit and casualty attendances and outpatient visits were excluded. There were 32,015 live births in the Northern region for the same year giving an admission rate in the first four weeks of life of 3.1 %. The median day of admission was 15. The mean length of stay was 3 days (median 2 days). 154 infants (0.48 % of all livebirths) were admitted on day 6 or before. We therefore suggest that in estimating that 4–5 % of all children need hospitalisation each year, Macfaul and Werneke may have underestimated this group and the demand for cubicles which stems from it. It is also likely that admissions in this age group will increase as length of stay of mothers and babies after delivery falls further. Dr Sam Oddie Dr Sam Richmond
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Russell Viner, Consultant in Adolescent Medicine & Endocrinology UCL Hospitals and Great Ormond Street Hospital, London
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R.Viner{at}ich.ucl.ac.uk Russell Viner
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Dear Editor I am disappointed that MacFaul and Wernecke's otherwise excellent article on trends in hospital use by children did not address inpatient bed use by adolescents. The need for separate inpatient facilities for adolescents is well-documented[1,2] is supported by over 80% of Paediatric Clinical Directors in the UK (unpublished survey by the InterCollegiate Working Party on Adolescent Health: J. Tripp), and is likely to be emphasised in the forthcoming National Service Framework for Children. Recent published evidence documents that bed usage by young people is higher than previously thought, and actually increases rather than decreases through the teenage years.[3] When planning hospital services for children, we must not focus merely on younger children, but also address the needs of adolescents - both those within the standard paediatric age-range and also those over 16 years. References |
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