Editor,—The only conclusion to be drawn from MacFaul et al’s article on parental and professional perception of need for emergency admission to hospital1 is the need for more studies in this area.

The study was retrospective and sampled a biased population—that is, parents of children who had been told their child needed hospital admission. Parents’ anxiety levels are highest at the time of admission and their perceived need for admission at this time tends to be based on emotion rather than information about their child’s illness. When a doctor has said the child is being admitted, most parents are not going to say that admission is unnecessary. When there is only moderate correlation between severity of illness score and need for admission score, it is an issue of parental education and the answer to this should not be automatic admission to hospital.

In the discussion, MacFaul et al acknowledge the limitations of their data collection methods but then draw rather dogmatic conclusions ignoring these limitations. They make only scant reference to models of successful alternatives to admission to hospital with assessment units and experienced home care …