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Abstract
Aim To test the hypothesis that children with neurological disabilities (ND) use a disproportionately greater amount of inpatient resources, looking specifically at 3 factors: the number of hospital admissions, total length of inpatient stay, and the reason for admission.
Methods A retrospective observational cross-sectional study was conducted, collecting the number of inpatient admissions, length of inpatient episodes and reasons for all admissions to three paediatric wards from 1st January 2015 to 31st March 2015.
Results Of the 942 inpatients, 148 children with ND were identified using ICD-10 codes. Across the three wards, children with ND accounted for 15.7% of inpatient population, 18.1% of hospital admissions, and 28.6% of the total inpatient days (Fig. 1).
Children with ND were also more likely to be re-admitted, with on average 0.202 (95% CI: 0.097–0.307) more admissions during the time period (p < 0.001*) compared to children without ND. Children with ND averaged 6.30 (95% CI: 3.07–9.55) more Total Inpatient Days (p < 0.001*), although this difference fell to 2.50 days using the transformed Total Inpatient Days which reduced the skewness of the data (Fig. 2).
A two-way ANOVA was conducted looking at the effect of Neurological Disability and Admission Reason on average total inpatient days (Fig. 3). Neurological disability significantly affected the average total length of inpatient stay (p < 0.001*). The admission reason also significantly affected the average total length of inpatient stay (p < 0.001*). There was a significant interaction between neurological disability and admission reason (p < 0.042**).
Conclusion Children with ND use disproportionately more inpatient resources than children without ND. Further work should be tailored to investigate the root cause. Future research could be conducted to see if these results of this study can be replicated at a national level. Longer and more frequent inpatient admissions may place children with ND at greater risk of nosocomial infections and medical errors, and this should be explored further.