Lack of peds preventive care ups unplanned hospital admissions
Elizabeth Cecil, Ph.D., from Imperial College London, and colleagues investigated the relationship between preventive primary care and risk for unplanned and ambulatory care sensitive (ACS) hospital admissions among 319,780 children registered from birth with 363 English practices. The children were born between January 2000 and March 2013.
The researchers found that 98 percent of children had complete vaccinations and 87 percent had development checks. Unplanned admission rates were 259 per 1,000 child-years for infants (<1 year), 105 per 1,000 child-years among preschool-aged children (aged 1 to 4 years), and 42 per 1,000 child-years among primary school children (aged 5 to 9 years). Infants with incomplete vaccination had an increased risk for all unplanned admissions (hazard ratio [HR], 1.89) and vaccine-preventable admissions (HR, 4.41). Infants lacking development checks also had a higher risk for unplanned admission (HR, 4.63). These associations remained across childhood. The risk for unplanned admission was higher among children who had higher consulting rates with primary care providers (preschool children: HR, 1.17). ACS infectious illness accounted for one-third of all unplanned admissions. There was also an increased risk for unplanned admission for children with chronic ACS conditions (asthma, diabetes, and epilepsy; HRs, 1.9, 11.43, and 4.82, respectively).
"Strengthening immunization coverage and preventive primary care in countries with poor universal health coverage could potentially significantly reduce the health burden from hospital admission in children," the authors write.
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