Readmission in children's emergency care: an analysis of hospital episode statistics

Callery, Peter; Kyle, Richard G.; Campbell, Malcolm; Banks, Michele; Kirk, Susan; Powell, Peter

doi:10.1136/adc.2009.163261

Cited by 10 publications

(26 citation statements)

References 13 publications

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“…Previous studies focused on adult populations,7 hospital factors5 8 or specific conditions9–11 and therefore have limited applicability to hospital care for CYP.…”

Section: Introductionmentioning

confidence: 99%

Who comes back with what: a retrospective database study on reasons for emergency readmission to hospital in children and young people in England

Wijlaars¹,

Hardelid

Woodman

et al. 2016

Arch Dis Child

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“…Previous studies focused on adult populations,7 hospital factors5 8 or specific conditions9–11 and therefore have limited applicability to hospital care for CYP.…”

Section: Introductionmentioning

confidence: 99%

Who comes back with what: a retrospective database study on reasons for emergency readmission to hospital in children and young people in England

Wijlaars¹,

Hardelid

Woodman

et al. 2016

Arch Dis Child

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show abstract

“…In contrast, other studies concluded that language spoken at home or single caregivers were associated with revisits 9 12 28 36 40 50 51 64. Next, we found conflicting evidence for the association between lower socioeconomic status and revisits 27 28 30 33 37 40 42 45…”

Section: Resultsmentioning

confidence: 95%

“…Two studies were positively associated with revisits,39 45 and three other studies were even associated with lower ED crowding during late evening or night shifts 32 40 46…”

Section: Resultsmentioning

confidence: 96%

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Tools for ‘safety netting’ in common paediatric illnesses: a systematic review in emergency care

et al. 2015

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ContextFollow-up strategies after emergency department (ED) discharge, alias safety netting, is often based on the gut feeling of the attending physician.ObjectiveTo systematically identify evaluated safety-netting strategies after ED discharge and to describe determinants of paediatric ED revisits.Data sourcesMEDLINE, Embase, CINAHL, Cochrane central, OvidSP, Web of Science, Google Scholar, PubMed.Study selectionStudies of any design reporting on safety netting/follow-up after ED discharge and/or determinants of ED revisits for the total paediatric population or specifically for children with fever, dyspnoea and/or gastroenteritis. Outcomes included complicated course of disease after initial ED visit (eg, revisits, hospitalisation).Data extractionTwo reviewers independently assessed studies for eligibility and study quality. As meta-analysis was not possible due to heterogeneity of studies, we performed a narrative synthesis of study results. A best-evidence synthesis was used to identify the level of evidence.ResultsWe summarised 58 studies, 36% (21/58) were assessed as having low risk of bias. Limited evidence was observed for different strategies of safety netting, with educational interventions being mostly studied. Young children, a relevant medical history, infectious/respiratory symptoms or seizures and progression/persistence of symptoms were strongly associated with ED revisits. Gender, emergency crowding, physicians’ characteristics and diagnostic tests and/or therapeutic interventions at the index visit were not associated with revisits.ConclusionsWithin the heterogeneous available evidence, we identified a set of strong determinants of revisits that identify high-risk groups in need for safety netting in paediatric emergency care being related to age and clinical symptoms. Gaps remain on intervention studies concerning specific application of a uniform safety-netting strategy and its included time frame.

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“…Asthma is a chronic condition which in the United Kingdom alone affects over 5.2 million people including 1.1 million children [6]. The UK together with the Republic of Ireland have the highest prevalence of asthma in the world [3]: it is the leading cause of hospital admissions particularly among children [7], and disproportionately affects certain ethnic groups and demographics [2]. The total cost of asthma is estimated to be £2.5 billion in the UK and Ireland and results in millions of lost working days [3].…”

Section: Introductionmentioning

confidence: 99%

Asthma Length of Stay in Hospitals in London 2001–2006: Demographic, Diagnostic and Temporal Factors

2011

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Asthma is a condition of significant public health concern associated with morbidity, mortality and healthcare utilisation. This study identifies key determinants of length of stay (LOS) associated with asthma-related hospital admissions in London, and further explores their effects on individuals. Subjects were primarily diagnosed and admitted for asthma in London between 1st January 2001 and 31st December 2006. All repeated admissions were treated uniquely as independent cases. Negative binomial regression was used to model the effect(s) of demographic, temporal and diagnostic factors on the LOS, taking into account the cluster effect of each patient's hospital attendance in London. The median and mean asthma LOS over the period of study were 2 and 3 days respectively. Admissions increased over the years from 8,308 (2001) to 10,554 (2006), but LOS consistently declined within the same period. Younger individuals were more likely to be admitted than the elderly, but the latter significantly had higher LOS (p<0.001). Respiratory related secondary diagnoses, age, and gender of the patient as well as day of the week and year of admission were important predictors of LOS. Asthma LOS can be predicted by socio-demographic factors, temporal and clinical factors using count models on hospital admission data. The procedure can be a useful tool for planning and resource allocation in health service provision.

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Readmission in children's emergency care: an analysis of hospital episode statistics

Cited by 10 publications

References 13 publications

Who comes back with what: a retrospective database study on reasons for emergency readmission to hospital in children and young people in England

Who comes back with what: a retrospective database study on reasons for emergency readmission to hospital in children and young people in England

Tools for ‘safety netting’ in common paediatric illnesses: a systematic review in emergency care

Asthma Length of Stay in Hospitals in London 2001–2006: Demographic, Diagnostic and Temporal Factors

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