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G24(P) Exploring the relationship between infectious disease and acute health seeking behaviour in the paediatric population
  1. FJ Taylor
  1. National Medical Director’s Clinical Fellow, Faculty of Medical Leadership and Management Clinical Fellow Scheme, London, UK

Abstract

Aims In the United Kingdom, over four and a half million paediatric emergency care attendances were recorded in 2010/11: across developed healthcare economies there has been a dramatic rise in the number of children attending secondary healthcare for non-urgent reasons. The majority of paediatric medical illness consists of self-limiting childhood infections, which can be managed in the community. Despite this, record numbers of children and young people are admitted to hospital, with most admissions lasting less than 24 h. This work explores how infectious disease in the paediatric population impacts on developed economy acute healthcare, and how the utilisation of these services as first contact for children and their caregivers affects the spread of infectious diseases.

Methods Literature searches in (i) NCBI PubMed using MeSH terms “Paediatrics”, “Paediatric Hospitals”, “Infection” and “Emergency Medicine” and (ii) Outbreak Database (an online database of nosocomial outbreaks). The results were hand sorted to include relevant papers and a thematic analysis performed along the themes of health-seeking behaviour and use of acute healthcare services for non-urgent care in paediatric infectious disease.

Results Regarding the impact of paediatric infectious disease in acute healthcare provision, three main themes emerged: (i) “Can’t cope”: Lack of understanding of infectious disease and the impact of socioeconomic stressors; (ii) “Won’t cope”: Phobia of risk, uncertainty regarding infectious disease and the cult of convenience and (iii) “No Hope”: Barriers to primary and preventative healthcare and failure of trust in healthcare professionals. Acute healthcare attendance can propagate infectious disease via contact with acute healthcare workers, cohorting in the waiting room and as a result of unnecessary admission to hospital.

Conclusions Families should be better supported by health visitor input and school education and by integration of primary and secondary care. Education in infectious disease for Paediatricians and General Practitioners will promote consistent messages regarding normal childhood illnesses. Debate is needed concerning mandatory vaccination of acute healthcare workers. New healthcare facilities need to be designed to allow for cohorting and separation of infectious cases, and more publicity given to hand and cough hygiene for children and their carers whilst in the acute healthcare setting.

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