Inequities in quality and safety outcomes for hospitalized children with intellectual disability

Abstract

To investigate if there are inequities in quality and safety outcomes for children with intellectual disability admitted to two tertiary paediatric hospitals.METHOD A cross-sectional study of 1367 admissions for 1018 randomly selected patients admitted for more than 23 hours to one of two tertiary children's hospitals in Sydney, Australia (1st January-31st December 2017). Electronic medical records were manually interrogated to identify children with intellectual disability (including developmental delay). Data extracted included patient demographics, length of stay, number of admissions, and reported clinical incidents. RESULTSIn total, 12.3% (n=125) of children admitted during the study period had intellectual disability, which represented 13.9% (n=190) of admissions. Sex and age at admission in children with and without intellectual disability were similar: 83 (43.7%) vs 507 (43.1%) females and 107 (56.3%) vs 670 (56.9%) males, p=0.875; median age 3 years (0-18y) vs 4 years (0-18y), p=0.122. Children with intellectual disability had significantly greater median length of stay (100.5h vs 79h, p<0.001) and cost of admission (A$11 596.38 vs A$8497.96) than their peers (p=0.001). Children with intellectual disability had more admissions with at least one incident compared to children without intellectual disability (14.7% vs 9.7%); this was not statistically significant (p=0.06).INTERPRETATION Children with intellectual disability experience inequitable quality and safety outcomes in hospital. Engaging children and families in clinical incident reporting may enhance understanding of safety risks for children with intellectual disability in hospital.

Codesigning patient experience measures for and with children and young people with intellectual disability: a study protocol

“…: 2019/ETH00367). 9 We found almost 14% of admissions were for a child or young person with intellectual disability or developmental delay. Furthermore, these children had a longer median length of stay, cost of admission and were over-represented in the reported clinical incident data.…”

‘Smiles and laughter and all those really great things’: Nurses' perceptions of good experiences of care for inpatient children and young people with intellectual disability

“…In Australia, 4.5% of children aged 15 years or under have intellectual disability (Australian Bureau of Statistics, 2018). A recent study found almost 14% of admissions to a tertiary paediatric healthcare organization were CYP with intellectual disability (Mimmo et al, 2021). These CYP also had more frequent admissions, a significantly longer median length of stay, and higher median cost of admission than their peers (Mimmo et al, 2021).…”

“…A recent study found almost 14% of admissions to a tertiary paediatric healthcare organization were CYP with intellectual disability (Mimmo et al, 2021). These CYP also had more frequent admissions, a significantly longer median length of stay, and higher median cost of admission than their peers (Mimmo et al, 2021). At the same time, inpatient CYP with intellectual disability and their parents consistently report poor quality and safety experiences.…”

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