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Potentially preventable hospitalisations in children: a comparison of definitions
  1. Alexandra M Procter1,
  2. Rhiannon M Pilkington1,
  3. John W Lynch1,2,
  4. Lisa G Smithers1,
  5. Catherine R Chittleborough1
  1. 1 School of Public Health, Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
  2. 2 Population Health Sciences, University of Bristol, Bristol, UK
  1. Correspondence to Alexandra M Procter, School of Public Health, Robinson Research Institute, The University of Adelaide, Adelaide, SA 5005, Australia; alexandra.procter{at}


Objective To compare admission rate, cumulative incidence and social distribution of potentially preventable hospitalisations (PPHs) among children according to the current Australian adult definition, and the child definition developed in New Zealand.

Design, setting, participants Deidentified, linked public hospital, births registry and perinatal data of children aged 0–10 years born 2002–2012 in South Australia (n=1 91 742).

Main outcome measures PPH admission rates among 0–10 year olds and cumulative incidence by age 5 under the adult and child definitions. Cumulative incidence was assessed across indicators of social and health disadvantage.

Results PPH admission rates among 0–10 year olds were 25.6 (95% CI 25.3 to 25.9) and 59.9 (95% CI 59.5 to 60.4) per 1000 person-years for the adult and child definitions, respectively. Greater absolute differences in admission rates between definitions were observed at younger ages (age <1 difference: 75.6 per 1000 person-years; age 10 difference: 1.4 per 1000 person-years). Cumulative incidence of PPHs among 0–5 year olds was higher under the child (25.0%, 95% CI 24.7 to 25.2) than the adult definition (12.8%, 95% CI 12.6 to 13.0). Higher PPH incidence was associated with social and health disadvantage. Approximately 80% of the difference in admission rate between definitions was due to five conditions.

Conclusions Respiratory conditions and gastroenteritis were key contributors to the higher PPH admission rate and cumulative incidence among children when calculated under the child definition compared to the adult definition. Irrespective of definition, higher PPH cumulative incidence was associated with social and health disadvantage at birth.

  • potentially preventable hospitalisations
  • children

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  • Contributors All authors contributed to the conception of the study. AMP conducted the analysis and wrote the first draft. CRC, RMP, LGS and JWL all provided critical editorial input.

  • Funding JWL has been awarded a National Health and Medical Research Council (NHMRC) Australia Fellowship (570120); and NHMRC Centre of Research Excellence (1099422); JWL, CRC and LGS were awarded an NHMRC Partnership Project Grant (1056888); and RMP is supported by funds from the NHMRC Centre for Research Excellence.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement No data are available. The data used in this study is not owned by the researchers and not publically available.