Emergency admissions to hospital have been increasing for children in the UK over the last decade. Whilst some of these admissions are necessary and appropriate, many are for conditions that may be treated effectively in the community, e.g. minor infectious illnesses. Babies who were born too early (preterm) are admitted to hospital more frequently than children who were not born early, due to both minor disorders and long-term health conditions that persist through later life (e.g. asthma, cerebral palsy or epilepsy). It is therefore particularly important that health services can properly care for the needs of this vulnerable group of children.
To avoid unnecessary emergency hospital admissions, we need to know how and when children born preterm have contact with health services. Linked anonymised hospital and GP data provides the opportunity to find out how health services could better care for children born preterm, outside of hospital settings. This study will firstly describe how preterm babies with different health conditions use primary care services. We will then explore the types of children who are more likely to be admitted to hospital in an emergency, to characterise families who could benefit from increased support outside of hospital.
We aim to describe the interaction between primary and secondary healthcare service use in children aged 1-10 years who were born preterm (<37 weeks gestation), and to explore individual and household determinants of emergency hospital use, by using 1) linkage with HES inpatient and A&E data; 2) the pregnancy register; and 3) the household indicator.
Firstly, we will describe patterns of health service use (number of regularity of primary and secondary care contacts) in children born preterm with different childhood chronic conditions. Secondly, we will use the CPRD household indicator to define household characteristics, e.g. number of siblings, number of adults, and health burden (total healthcare contacts per person-year). To identify determinants of variation in emergency healthcare use, we will model the number of emergency hospital admissions per child-year, evaluating the effects of primary care contacts, individual risk-factors, and household characteristics.
This study will help identify vulnerable households who may be at risk of unnecessary hospital contacts and who would most benefit from increased support in the community. This evidence will help policy makers and commissioners make informed decisions about the best ways to meet the needs of these families through maternity and paediatric services.
• Primary care consultations • Unplanned inpatient admissions • A&E visits
Katie Harron - Chief Investigator - University College London ( UCL )
Katie Harron - Corresponding Applicant - University College London ( UCL )
Caroline Minassian - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
David Cromwell - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Jan van der Meulen - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Liam Smeeth - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Maria-Luisa Pettigrew - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Ruth Gilbert - Collaborator - University College London ( UCL )
Sara Thomas - Collaborator - Not from an Organisation
CPRD Mother-Baby Link;CPRD Mother-Baby Link;HES Accident and Emergency;HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation