Prolonged length of stay for acute hospital admissions as the increasing of age: A nationwide population study for Taiwan's patients with cerebral palsy

Chiang, Kuo-Liang; Huang, Chin‐Yin; Fan, Hueng-Chuen; Kuo, Fang-Chuan

doi:10.1016/j.pedneo.2018.04.004

Cited by 11 publications

(28 citation statements)

References 24 publications

(18 reference statements)

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“…The high rate of respiratory presentations is consistent with previous literature on respiratory risk factors in those with CP, alongside published studies on inpatient hospital admissions in this cohort 12,18,22 . Study results also showed an increase in rates of pneumonia between paediatric and adult cohorts.…”

Section: Discussionsupporting

confidence: 90%

Emergency department usage by adults with cerebral palsy: A retrospective cohort study

Gill

Morgan

Enticott

2021

Emerg Medicine Australasia

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Objective To retrospectively profile the ED usage for a cohort of adults with cerebral palsy (CP). Methods Five years of ED data from a Victorian hospital network was analysed to identify participants with CP using the Victorian Emergency Minimum Dataset supplemented with scrutiny of inpatient admission data to identify cases because of limited ED coding of CP. Presentation frequency, emergency diagnoses (International Classification of Diseases, 10th Revision codes) and presentation sequelae were calculated and described. An investigation into rates of low urgency presentations was conducted. Differences between adult and paediatric cohorts were described. Results Participants with CP constituted 1586 ED presentations. Adults represented 43% (n = 689) of these. Thirty percent of adults presented more than five times over the study period, with respiratory (25%), gastrointestinal (17%) and epilepsy/convulsion diagnoses (11%) being the most common presentations. Rates of inpatient hospital admissions from the ED increased with age in adults (P < 0.001). Low urgency presentations made up 8.9% of total adult presentations. Conclusions The high rates of respiratory diagnoses and epilepsy/convulsions, both ambulatory care‐sensitive conditions, may be indicative of transitional challenges between paediatric and adult healthcare, potentially highlighting difficulties in accessing primary care services. Relatively low rates of ‘low urgency’ presentations may suggest perceived medical fragility in this vulnerable population. People with CP who present to ED and were not admitted may be underrepresented in this data. National expansion of this research will aid the development of an evidence‐based model of care for CP in Australia.

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Section: Discussionsupporting

confidence: 90%

Emergency department usage by adults with cerebral palsy: A retrospective cohort study

Gill

Morgan

Enticott

2021

Emerg Medicine Australasia

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“…Adults had 67 (95% CI: 37–123) hospital admissions per 100 person‐years ( I 2 =99.9%; p <0.001) 33,46,48,54,56 . This equates to 67 visits among 100 adults with CP observed for 1 year.…”

Section: Resultsmentioning

confidence: 97%

Health service use among adults with cerebral palsy: a mixed‐methods systematic review

Manikandan

Kerr²,

Lavelle

et al. 2021

Develop Med Child Neuro

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Aim To determine the proportion of adults with cerebral palsy (CP) using health services and frequency of use, and to explore experiences and perceptions of health services for this population. Method A mixed‐methods systematic review was conducted using the Joanna Briggs Institute methodology. Five databases were searched to September 2020. Observational and qualitative studies were included. Two reviewers screened titles, abstracts, and full texts; extracted data; and assessed the quality of included studies. Separate meta‐analyses were used to pool the proportion of adults using each service and frequency of use. A meta‐aggregation approach was used to synthesize qualitative data. Quantitative and qualitative findings were integrated using the Andersen and Newman Model of health care utilization. Results Fifty‐seven studies (31 quantitative, 26 qualitative) of 14 300 adults with CP were included. The proportion of adults using services ranged from 7% (95% confidence interval [CI]: 2–13%) for urologists to 84% (95% CI: 78–90%) for general practitioners. Incidence of visits ranged from 67 (95% CI: 37–123) hospital admissions to 404 (95% CI: 175–934) general practitioner visits per 100 person‐years. Qualitative themes highlighted issues regarding accessibility, caregivers’ involvement, health workers’ expertise, unmet ageing needs, transition, and health system challenges. Interpretation Adults with CP used a wide range of health services but faced context‐specific challenges in accessing required care. Appropriate service delivery models for adults with CP are required. This review emphasizes a need to develop an appropriate service model for adults with CP to meet their needs.

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“…Some medical problems experienced by children with CP therefore may be more prevalent or specific to childhood, limiting confidence in applying this information to adults ageing with CP. A Taiwanese study reported that in 3709 young adults with CP (mean age 24y) pneumonia, other respiratory problems, and epilepsy were the top three reasons for hospital admission 9 . The most common reasons for admissions among young adults with CP (mean age 26y) in a Canadian cohort were also pneumonia and epilepsy, followed by mental illness, lower gastrointestinal problems/constipation, and malnutrition or dehydration.…”

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confidence: 99%

Profile of hospital admissions for adults with cerebral palsy: a retrospective cohort study

Morgan

Enticott

Nikam

et al. 2020

Develop Med Child Neuro

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Aim To retrospectively profile acute hospital admissions for a defined cohort of adults with cerebral palsy (CP). Method Five years of health service data were interrogated to identify acute health service use by adults with CP. Admission types were described, admission reasons categorized using International Classification of Diseases, 10th Revision codes, and length of stay (LOS) calculated. Any differences between paediatric and adult subsets were explored. Results Individuals with CP constituted 2922 admissions. Of these, 850 (29%) were adult admissions. There were significant differences between admission reasons for paediatric and adult cohorts, with adults predominantly seeking hospital admission for emergency rather than planned care (emergency reason: adults 62.1%, paediatrics 25.2%; p<0.001). The median adult admission LOS was longer than that of children (p<0.001). The primary diagnosis admission reason in the adult data set was respiratory illness (20%) followed closely by gastrostomy dysfunction (19%). Interpretation Adults with CP predominantly access acute hospital services for emergency health care. A high frequency of admissions is associated with respiratory illness and gastrostomy dysfunction in adults with CP. Adults with cerebral palsy (CP) access acute inpatient services for emergency health care. Hospital admissions are predominantly because of respiratory illness and gastrostomy dysfunction. Admission length of stay is longer for adults than children. Many adults with CP require hospitalization more than once a year.

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Prolonged length of stay for acute hospital admissions as the increasing of age: A nationwide population study for Taiwan's patients with cerebral palsy

Cited by 11 publications

References 24 publications

Emergency department usage by adults with cerebral palsy: A retrospective cohort study

Emergency department usage by adults with cerebral palsy: A retrospective cohort study

Health service use among adults with cerebral palsy: a mixed‐methods systematic review

Profile of hospital admissions for adults with cerebral palsy: a retrospective cohort study

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