Appropriateness of paediatric admission.

MacFaul, R; Glass, EN; Jones, Steve T.

doi:10.1136/adc.71.1.50

Cited by 36 publications

(30 citation statements)

References 16 publications

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“…The study also showed that respiratory symptoms of wheezing and cough were the leading cause of hospital admission and that asthma was the most common diagnosis. This finding is in agreement with other studies [8,9] that asthma was the single most common cause for admission. A study from Australia reported that asthma remained the second most common cause for admission to the paediatric hospital [10].…”

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confidence: 83%

Aetiology of Febrile Illnesses Presenting to a District Hospital

El-Radhi¹,

Patel²

2017

Pediatric Infect Dis

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Little attention has been given to the patterns of diseases in children admitted to a hospital. We retrospectively studied 874 children (477 male, 397 female) who were hospitalised consecutively during a ten months period to determine the incidence and types of their illness with an emphasis on patterns and causes of fever.Respiratory symptoms of cough and wheezing were the single most common presenting cause of admission (20.3%). Fever (defined as one temperature record of >38.0°C or two successive record of 37.8°C) was the second most common presenting cause (15.8%) leading to admission, and within this group fever without focus was most common. Overall, fever was recorded in 35.9% of the study group. Urinary tract infection was the most common bacterial infection. Children with bacterial infections were usually febrile while the majority of those with presumed viral infections were afebrile. The mean body temperature in children with bacterial infections was significantly higher than in those with presumed viral infections. Overall, febrile children stayed significantly longer in hospital and underwent more laboratory tests compared with afebrile children. Although white blood count and C-reactive protein tended to be higher in bacterial than in presumed viral infections, both tests were sometimes normal in serious bacterial infections and abnormally high in presumed viral diseases. Mild hyponatraemia (<135 mmol/L) was a common laboratory finding in febrile illness, and severe hyponatraemia (<130 mmol/L), was more common in bacterial diseases.It is concluded that febrile illnesses are common and only second to respiratory diseases as the leading cause of hospitalisation. Children with bacterial infection are usually febrile and those with high fever should be evaluated for serious bacterial diseases. Those children who present with fever without focus should be evaluated for an underlying urinary tract infection and bacteraemia.

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supporting

confidence: 83%

Aetiology of Febrile Illnesses Presenting to a District Hospital

El-Radhi¹,

Patel²

2017

Pediatric Infect Dis

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“…About 20% of admissions of children are categorized as 'inappropriate' or 'ambulatory care sensitive (ACS)', i.e., conditions which according to either the receiving physician or a classification system do not require hospitalization [29][30]. The admitting physician's judgment of the capability of the parents to take care of their sick child at home may influence the decision of admission.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic factors and risk of hospitalization with infectious diseases in 0- to 2-year-old Danish children

et al. 2005

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Although the association between low socioeconomic status and illness in childhood is well known, the impact of socioeconomic factors on risk and frequency of hospitalizations for infectious diseases, the most frequent disease category, during the first 2 years of life has scarcely been studied. Through linkage of records drawn from public administrative and health registries, we conducted a population-based cohort study of 5024 Danish children born in 1997 to examine the frequency of hospitalization for infectious diseases in very young children. The main exposure variables, adjusted for potential confounding factors, were mother's education level, household income, and cohabitation status. The outcome was number of hospital admissions (0, 1-2, or 3+) for infectious diseases. A total of 737 children (14.7%) were admitted to hospital 1-2 times, and 83 (1.6%) were admitted 3-10 times. The risk of hospitalization was increased in children of mothers with a low level of education compared with vocational education (1-2 admissions: adjusted odds ratio (OR) 1.3 (95% confidence interval [CI]: 1.1-1.6). Children from low-income families had an increased risk of 3 or more admissions (low cf middle income: adjusted OR 2.0 [95% CI: 0.6-6.0]). Children of single mothers had an increased risk of hospitalization (1-2 admissions: adjusted OR 1.7 [95% CI: 1.1-2.6]. We found the highest risk of hospitalization for infectious diseases in children of mothers with only basic schooling, and particularly among those coming from single parent homes with a low income.

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“…It is not possible to infer whether a high admission rate represents a high need for admission or variation in medical practice. 30,31 Admission rates may be higher from localities with easy access to hospital or vary with clinical and parental thresholds for admission and organization of out of hours primary care services. 32 The rate of emergency hospital admission for respiratory infections in children has increased over the past decade in the United Kingdom.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…32 The rate of emergency hospital admission for respiratory infections in children has increased over the past decade in the United Kingdom. 31 The majority were shortstay admissions, 33,34 suggesting that these were for minor illness episodes that could have been managed in the community. 33 Additional investigation is required to identify differences in health-seeking behavior and thresholds for admission, and presentation, to hospital.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Gestational Age, Birth Weight, and Risk of Respiratory Hospital Admission in Childhood

et al. 2013

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OBJECTIVE: To investigate the risk of emergency respiratory hospital admission during childhood associated with gestational age at birth and growth restriction in utero. METHODS: The study included a total population electronic birth cohort with anonymized record-linkage of multiple health and administrative data sets. Participants were 318 613 children born in Wales, United Kingdom, between May 1, 1998, and December 31, 2008. The main outcome measure was emergency respiratory hospital admissions. RESULTS: The rate of admission in the first year of life ranged from 41.5 per 100 child-years for infants born before 33 weeks’ gestation to 9.8 per 100 child-years for infants born at 40 to 42 weeks’ gestation. The risk of any emergency respiratory admission up to age 5 years increased as gestational age decreased to <40 weeks. Even at 39 weeks’ gestation, there was an increased risk of emergency hospital admissions for respiratory conditions compared with infants born at 40 to 42 weeks (adjusted hazard ratio 1.10; 95% confidence interval 1.08–1.13). Small for gestational age (<10th centile for gestation and gender-specific birth weight) was independently associated with an increased risk of any emergency respiratory admission to hospital (adjusted hazard ratio 1.07; 95% confidence interval 1.04–1.10). CONCLUSIONS: The risk of emergency respiratory admission up to age 5 years decreased with each successive week in gestation up to 40 to 42 weeks. Although the magnitude of increased risk associated with moderate and late preterm births is small, the number of infants affected is large and therefore presents a significant impact on health care services.

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Appropriateness of paediatric admission.

Cited by 36 publications

References 16 publications

Aetiology of Febrile Illnesses Presenting to a District Hospital

Aetiology of Febrile Illnesses Presenting to a District Hospital

Socioeconomic factors and risk of hospitalization with infectious diseases in 0- to 2-year-old Danish children

Gestational Age, Birth Weight, and Risk of Respiratory Hospital Admission in Childhood

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