U.K. research offers lessons for Canadian health care
(Edmonton) Peter Gill, a Rhodes Scholar from the University of Alberta’s Faculty of Medicine & Dentistry, and his research team just published findings that show a 28 per cent increase in the number of emergency hospital admissions for children in the United Kingdom over 12 years. This accounts for a total of 7.7 million hospital admissions.
Most children admitted for emergencies had conditions that could be cared for at home, such as urinary tract infections, respiratory tract infections and gastroenteritis; there were fewer admissions for kids with chronic conditions. Most of the hospital stays were very short; stays of one day or less increased twofold throughout the length of the study.
The findings were published in the peer-reviewed journal Archives of Disease in Childhood, a subsidiary publication of the British Medical Journal. The study looked at admissions for children under the age of 15, noting a steady increase each year since 2003. Emergency admissions of children under the age of one were particularly high, with a 52 per cent increase over the 12-year span. Admissions for children between the ages of one and four rose by 25 per cent over the same time period. In 2010, two-thirds of all children admitted to emergency were under the age of five—accounting for more than 500,000 admissions.
Gill and his team said that if the emergency hospitalization rate for children under the age of five continues at this rate, about 731,000 children in this age group will be admitted to hospital in the U.K. in 2020.
“We were surprised how high and how substantial the increase was, particularly for the same-day, short stays, which likely suggests these children don’t necessarily need to be admitted to hospital,” said Gill. “These children could likely be cared for at home or in the community setting.”
The research team noted hospital admissions are costly and can put children at increased risk of “hospital-acquired infections, medical errors, drug reactions and emotional trauma.”
Gill says there have been major policy changes to the way health care is delivered in the U.K. since 2000, such as implementing emergency wait-time targets of four hours, allowing family doctors to opt out of providing care on evenings and weekends, and rolling out a health-care phone assistance line that frequently encourages parents to take their children to the hospital. Add anxious moms and dads to the mix, as well as junior residents who are nervous about a perceived increase in the number of medical lawsuits, and there are many factors contributing to the increase in admissions, he says.
“It’s a fairly controversial topic because everyone wants to point a finger at who is to blame,” Gill said. “It’s so complicated, it’s difficult to pin down one particular cause because there have been so many policy changes. I think it’s a good idea to do studies like this after major policy changes are made to the health-care system, to see if there are any unintended negative consequences from those changes. That’s why research is so important.”
The Rhodes Scholar says his research is very relevant to the Canadian health-care system, noting he hopes to use the knowledge he has gained when he returns to Canada to work as a physician.
Gill is working on his PhD at Oxford University in the U.K., examining the quality of care delivered to children. He will finish his studies this summer, after which he plans to return to the U of A to finish his fourth year of medical school, then specialize in pediatrics.