RT Journal Article
SR Electronic
T1 Effects of consultant residence out-of-hours on acute paediatric admissions
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 661
OP 663
DO 10.1136/archdischild-2019-317553
VO 105
IS 7
A1 Robert Scott-Jupp
A1 Emily Carter
A1 Nick Brown
YR 2020
UL http://adc.bmj.com/content/105/7/661.abstract
AB Acute paediatric units require round-the-clock skilled resident medical cover. Fully trained doctors remaining resident on-site at night and weekends may improve care at these times, but costs are higher. In compensation, more senior doctors may be less likely to admit children.Methods In a unit providing 24-hour, 7-day acute services, out-of-hours resident cover has been divided between level 2/3 trainees and consultants. Between 2007 and 2017, night and weekend day shifts were identified as resident consultant or non-resident consultant. Admission numbers (duration of stay of ≥4 hours) were obtained from hospital activity databases. Analyses were undertaken on total admissions and stratified by time of day and duration of stay of >12 or < 12 hours. Incidence rate ratios (IRRs) were derived using negative binomial regression .Results For all out-of-hours and short-stay patients, children were significantly more likely to be admitted when there was no resident consultant: IRRs 1.07 (95% CI 1.04 to 1.09) and 1.09 (95% CI 1.02 to 1.18), respectively. There was no difference between rates stratified into long stay at night or weekend days: IRRs 1.01 (95% CI 0.96 to 1.07) and 1.03 (95% CI 0.99 to 1.18) respectively .Conclusion A resident consultant presence was associated with reduced total, night-time and short-stay admissions.