Childhood disadvantage and emergency admission rates for common presentations in London: an exploratory analysis
- Richard G Kyle1,
- Marina Kukanova2,
- Malcolm Campbell3,
- Ingrid Wolfe4,5,
- Peter Powell6,
- Peter Callery3
- 1Cancer Care Research Centre, Department of Nursing and Midwifery, University of Stirling, Stirling, UK
- 2London School of Hygiene and Tropical Medicine, London, UK
- 3School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
- 4London School of Hygiene and Tropical Medicine, London, UK
- 5Whittington Hospital, London, UK
- 6West Suffolk Hospital, Bury St Edmunds, UK
- Correspondence to R G Kyle, Cancer Care Research Centre, Department of Nursing and Midwifery, University of Stirling, Stirling FK9 4LA, UK;
Contributors Carol Ewing, Clinical Workforce Lead, Children, Young People and Families Network, Consultant Paediatrician, Royal Manchester Children's Hospital. RGK obtained secondary data, designed and conducted data analysis, contributed to interpretation, drafted and revised the manuscript and approved the final version.MK obtained HES data, commented on revisions to the manuscript and approved the final version.MC helped shape the analysis and interpretation, commented on revisions to the manuscript and approved the final version.IW assisted with data interpretation, commented on revisions to the manuscript and approved the final version.PP assisted with data interpretation, commented on revisions to the manuscript and approved the final version.PC shaped the analysis and conducted interpretation, drafted and revised the manuscript and approved the final version.
- Accepted 17 August 2010
- Published Online First 29 September 2010
Aim To determine whether emergency hospital admission rates (EAR) for common paediatric conditions in Greater London are associated with measures of child well-being and deprivation.
Design Retrospective analysis of hospital episode statistics and secondary analysis of the Index of Multiple Deprivation (IMD) 2007 and Local Index of Child Well-Being (CWI) 2009.
Setting 31 Greater London primary care trusts (PCTs).
Outcome measures EAR in PCTs for breathing difficulty, feverish illness and/or diarrhoea.
Results 24 481 children under 15 years of age were discharged following emergency admission for breathing difficulty, feverish illness and/or diarrhoea during 2007/2008. The EAR for breathing difficulty was associated with the IMD (Spearman's rho 0.59, p<0.001) and IMD indicators of: overcrowding (Spearman's rho 0.62, p<0.001), houses in poor condition (Spearman's rho 0.55, p=0.001), air quality (Spearman's rho 0.53, p=0.002), homelessness (Spearman's rho 0.44, p=0.013), and domains of the CWI: housing (Spearman's rho 0.64, p<0.001), children in need (Spearman's rho 0.62, p<0.001), material (Spearman's rho 0.58, p=0.001) and environment (Spearman's rho 0.53, p=0.002). There were no statistically significant relationships between the EAR of children admitted for feverish illness and diarrhoea or aged under 1 year for any condition, and the IMD, either IMD indicators or CWI domains.
Conclusions Housing and environmental factors are associated with children's demand for hospital admission for breathing difficulty. Some associations are stronger with the CWI than the IMD. The CWI has potential to identify priority PCTs for housing and environment interventions that could have specific public health benefits for respiratory conditions.
The data sources were Hospital Episode Statistics (inpatient data) 2007/08, The NHS Information Centre for Health and Social Care; Indices of Multiple Deprivation 2007, Local Index of Child Well-Being 2009, Communities and Local Government; Mid-Year Estimates 2007, Office for National Statistics.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.