BackgroundAdmission of infants to hospital with bronchiolitis consumes considerable healthcare resources each winter. We report an analysis of hospital admissions in England over five decades.MethodsData were analysed from the Hospital In-Patient Enquiry (HIPE, 1968–1985), Hospital Episode Statistics (HES, 1989–2011), Oxford Record Linkage Study (ORLS, 1963–2011) and Paediatric Intensive Care Audit Network (PICANet, 2003–2012). Cases were identified using International Classification of Diseases (ICD) codes in discharge records. Bronchiolitis was given a separate code in ICD9 (used in England from 1979). Geographical variation was analysed using Local Authority area boundaries. Maternal and perinatal risk factors associated with bronchiolitis and subsequent admissions for asthma were analysed using record-linkage.ResultsAll-England HIPE and HES data recorded 468 138 episodes of admission for bronchiolitis in infants aged <1 year between 1979 and 2011. In 2011 the estimated annual hospital admission rate was 46.1 (95% CI 45.6 to 46.6) per 1000 infants aged <1 year. Between 2004 and 2011 the rates rose by an average of 1.8% per year in the all-England HES data, whereas admission rates to paediatric intensive care changed little (1.3 to 1.6 per 1000 infants aged <1 year). A fivefold geographical variation in hospital admission rates was observed. Young maternal age, low social class, low birth weight and maternal smoking were among factors associated with an increased risk of hospital admission with bronchiolitis.ConclusionsHospital admissions for infants with bronchiolitis have increased substantially in recent years. However, cases requiring intensive care have changed little since 2004.
This paper presents the results of an exploratory study linking the national data-sets for all children in need and child protection services in England. The study was informed by an emerging literature on systems thinking in public services, and aimed to examine variations and patterns of response in local authorities to demand for child welfare services in their area. One hundred and fifty-two local authority census returns and other statistical indicators covering up to a thirteen-year period were combined into a single data-set. Statistical analysis was undertaken to explore the characteristics of demand, workload and workforce, trends over time and variations between local authorities. The results showed that the overall system has become increasingly geared towards protective interventions, especially since the Baby P scandal of 2008. Deprivation levels continue to be the key driver of referrals and other categories of demand, and are strongly associated with variations in service response, particularly in the initial stages of referral and assessment. Implications are considered for the current organisation of child welfare services in light of recent reviews and reforms.
This article presents findings from a quantitative study of the national data-sets for statutory children’s social care services in England. The aim of the study was to examine how demand management varied in local authorities with differing levels of area deprivation. About 152 local authorities census returns and other statistical indicators covering the period 2014–2017 were combined into a single data-set. Statistical analysis was undertaken to explore trends over time and correlations between indicators that might indicate patterns in the way demand was managed. Findings showed that high levels of deprivation have continued to be strongly linked to high levels of activity and that local authorities have continued to increase their use of protective interventions relative to referrals. Evidence was found for three interconnected mechanisms, through which local authorities tended to manage demand for services: screening, rationing and workforce churn. The article describes these mechanisms and comments on their significance for the current crisis of demand in the sector.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.