Increasing Short-Stay Unplanned Hospital Admissions among Children in England; Time Trends Analysis ’97–‘06 英文参考文献.docVIP
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Increasing Short-Stay Unplanned Hospital Admissions among Children in England; Time Trends Analysis ’97–‘06 英文参考文献
IncreasingShort-StayUnplannedHospitalAdmissions
amongChildreninEngland;TimeTrendsAnalysis’97–‘06
SoniaSaxena1*,AlexBottle1,RuthGilbert2,MikeSharland3
1Department ofPrimary Careand Social Medicine, Imperial College London, London, United Kingdom, 2Centre for Evidence-based ChildHealth and MRC Centre of
Epidemiologyfor Child Health, UCL-Institute of Child Health, London, United Kingdom, 3PaediatricInfectiousDiseases Unit, St George’sHospital NHS Trust, London,
UnitedKingdom
Abstract
Background: Timely care by general practitioners in the community keeps children out of hospital and provides better
continuityofcare.YetintheUK,accesstoprimarycarehasdiminishedsince2004whenchangesingeneralpractitioners’
contractsenabledthemto‘optout’ofprovidingout-of-hourscareandsincethenunplannedpediatrichospitaladmission
rateshaveescalated,particularlythroughemergencydepartments.Wehypothesisedthatanyincreaseinisolatedshortstay
admissions for childhood illness might reflect failure to manage these cases in the community over a 10 year period
spanningthesechanges.
Methods and Findings: We conducted a population based time trends study of major causes of hospital admission in
children ,10 years using the Hospital Episode Statistics database, which records all admissions to all NHS hospitals in
EnglandusingICD10codes.Outcomesmeasuresweretotalandisolatedshortstayunplannedhospitaladmissions(lasting
lessthan2dayswithoutreadmissionwithin28days)from1997to2006.Overtheperiodannualunplannedadmissionrates
inchildrenaged,10yearsroseby22%(from73.6/1000to89.5/1000childyears)withlargerincreasesof41%inisolated
shortstayadmissions(from42.7/1000to60.2/1000childyears).Therewasasmallerfallof12%inadmissionswithlengthof
stayof.2days.By2006,67.3%ofallunplannedadmissionswereisolatedshortstays,2days.Theincreasesinadmission
ratesweregreaterforcommonnon-infectiousthaninfectiouscausesofadmissions.
Conclusions:ShortstayunplannedhospitaladmissionratesinyoungchildreninEnglandhaveincreasedsubstantiallyin
recent years
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