Increase in emergency admissions

Gill and colleagues report a sustained year on year increase in emergency paediatric admissions over the last 10 years; 63 per 1000 in 1999, 81 per 1000 in 2010. This is by analysis of Hospital Episode Statistics (under 14 years of age) and population estimates for England. Most of the increase (2 fold) is in admissions for less than 24 h offsetting a small decline in admissions for greater than 24 h. Considering specific conditions admissions rates for upper respiratory tract infection rose by 22%, lower respiratory tract infection by 40%, urinary tract Infections by 43% and gastroenteritis by 31% whereas admission rates for chronic conditions fell by 5.6%. The increase in admissions is likely, at least in part, to reflect changes in health care delivery with the 4 h wait target in emergency departments and increased dependence on paediatric assessment units for the assessment and management of children presenting with acute illness. Other factors such as referral thresholds/parental expectations and rapid access to investigation and diagnosis may also play a role. This important change and its potential causation is discussed at length by the authors …