Changing characteristics of hospital admissions but not the children admitted—a whole population study between 2000 and 2013

There are increasing numbers of emergency medical paediatric admissions. Our hypothesis was that characteristics of children and details of their emergency admissions are also changing over time. Details of emergency admissions in Scotland 2000-2013 were analysed. There were 574,043 emergency admissions, median age 2.3 years. The age distribution, proportion of boys and socioeconomic status of children admitted was essentially unchanged. Emergency admissions rose by 49% from 36.2/1000 children per annum to 54.1/1000 between 2000 and 2013. Emergency admissions that were discharged on the same day rose by 186% from 8.6/1000 to 24.6/1000. The mean duration of emergency admission fell from 1.7 to 1.1 days. The odds for an emergency admission with upper respiratory infection, “viral infection”, tonsillitis, bronchiolitis and lower respiratory tract infection all rose. In contrast the absolute numbers and odds for an emergency admission with asthma and diarrhoea and vomiting fell.
Conclusions. The demographics of children with emergency admissions have not changed substantially but characteristics of admissions have changed considerably, in particular admissions which are short stay and due to respiratory infection are much more common. The fall in the absolute number of children with some acute medical diagnoses suggests that the rise in admissions is not necessarily inexorable.