Increase in emergency admissions to hospital for children in England

PGThere are currently pressures on those working in primary care settings to reduce hospital admissions yet acute admissions for children continue to rise.  This article on British children was the first detailed analysis of emergency admissions for conditions that are usually managed at home.  We identified a year-on-year rise in emergency admissions since 2003 which represents a huge cost burden to the healthcare system and society.  Much of the rise was for common self-limiting infections which suggests a systematic failure both in primary and secondary care in the management of children with acute minor infections.  The timing of the rise also suggests that the introduction of 4-hour waiting time targets in emergency departments and changes to the arrangements of out-of-hours care in family medicine may have played an important role.

Impact
The article was accompanied by a BMJ Journals Press Release, a commissioned editorial, and received extensive news and radio coverage, including BBC News and the Telegraph, for questioning how children’s services were delivered in England.  It stimulated spin-off work in Scotland to evaluate whether trends are similar, and has provoked a broader discourse on the delivery of urgent care to children.  Since published, the article has been cited 14 times including in Lancet’s European Health series, viewed 6,192 times, and used as written evidence for the UK Parliament Health Committee on behalf of the Royal College of Paediatrics and Child Health.

Publications

Associated media
Do we need to change the way we deliver unscheduled care? Powell C. Arch Dis Child 2013;98:319-320 doi:10.1136/archdischild-2012-303562
Highlights from this issue. Increase in emergency admissions. Beatie M. Arch Dis Child 2013;98:i doi:10.1136/archdischild-2013-304164
BBC News – Child hospital stays ‘keep rising’ 11 Feb 2013 – The number of children being admitted to hospital each year in England has increased over the past decade, according to researchers.
The Telegraph – ‘Systematic’ failures by GPs lead to rise in children admitted to hospital as emergencies 12 Feb 2013 – A ‘systematic failure’ by GPs and hospitals has led to a 50 per cent rise in the number of under fives being admitted to wards as emergencies in the last decade, researchers have said.