Factors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional study
Abstract Background Identifying factors predictive of hospital admission can be useful to prospectively inform bed management and patient flow strategies and decrease emergency department (ED) crowding. It is largely unknown if admission rate or factors predictive of admission vary based on the popu...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09403-w |
| _version_ | 1797275337562783744 |
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| author | Julia Crilly Amy Sweeny Åsa Muntlin David Green Lorelle Malyon Luke Christofis Malcolm Higgins Ann-Sofie Källberg Sara Dellner Åsa Myrelid Therese Djärv Katarina E. Göransson |
| author_facet | Julia Crilly Amy Sweeny Åsa Muntlin David Green Lorelle Malyon Luke Christofis Malcolm Higgins Ann-Sofie Källberg Sara Dellner Åsa Myrelid Therese Djärv Katarina E. Göransson |
| author_sort | Julia Crilly |
| collection | DOAJ |
| description | Abstract Background Identifying factors predictive of hospital admission can be useful to prospectively inform bed management and patient flow strategies and decrease emergency department (ED) crowding. It is largely unknown if admission rate or factors predictive of admission vary based on the population to which the ED served (i.e., children only, or both adults and children). This study aimed to describe the profile and identify factors predictive of hospital admission for children who presented to four EDs in Australia and one ED in Sweden. Methods A multi-site observational cross-sectional study using routinely collected data pertaining to ED presentations made by children < 18 years of age between July 1, 2011 and October 31, 2012. Univariate and multivariate analysis were undertaken to determine factors predictive of hospital admission. Results Of the 151,647 ED presentations made during the study period, 22% resulted in hospital admission. Admission rate varied by site; the children’s EDs in Australia had higher admission rates (South Australia: 26%, Queensland: 23%) than the mixed (adult and children’s) EDs (South Australia: 13%, Queensland: 17%, Sweden: 18%). Factors most predictive of hospital admission for children, after controlling for triage category, included hospital type (children’s only) adjusted odds ratio (aOR):2.3 (95%CI: 2.2–2.4), arrival by ambulance aOR:2.8 (95%CI: 2.7–2.9), referral from primary health aOR:1.5 (95%CI: 1.4–1.6) and presentation with a respiratory or gastrointestinal condition (aOR:2.6, 95%CI: 2.5–2.8 and aOR:1.5, 95%CI: 1.4–1.6, respectively). Predictors were similar when each site was considered separately. Conclusions Although the characteristics of children varied by site, factors predictive of hospital admission were mostly similar. The awareness of these factors predicting the need for hospital admission can support the development of clinical pathways. |
| first_indexed | 2024-03-07T15:12:52Z |
| format | Article |
| id | doaj.art-389d999f67eb4060a4aa8db445cdee33 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-07T15:12:52Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-389d999f67eb4060a4aa8db445cdee332024-03-05T18:05:01ZengBMCBMC Health Services Research1472-69632024-02-0124111410.1186/s12913-023-09403-wFactors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional studyJulia Crilly0Amy Sweeny1Åsa Muntlin2David Green3Lorelle Malyon4Luke Christofis5Malcolm Higgins6Ann-Sofie Källberg7Sara Dellner8Åsa Myrelid9Therese Djärv10Katarina E. Göransson11Department of Emergency Medicine, Gold Coast HealthDepartment of Emergency Medicine, Gold Coast HealthDepartment of Medical Sciences/Clinical Epidemiology, Uppsala UniversityDepartment of Emergency Medicine, Gold Coast HealthEmergency Department, Queensland Children’s Hospital, Children’s Health QueenslandEmergency Department, Lyell McEwin Hospital, Elizabeth ValePaediatric Emergency Department, Women’s and Children’s HospitalSchool of Health and Welfare, Dalarna UniversityMaternal Health Care Unit, Region StockholmDepartment of Women’s and Children’s Health, Uppsala University Children’s HospitalEmergency and Reparative Medicine Theme, Karolinska University HospitalSchool of Health and Welfare, Dalarna UniversityAbstract Background Identifying factors predictive of hospital admission can be useful to prospectively inform bed management and patient flow strategies and decrease emergency department (ED) crowding. It is largely unknown if admission rate or factors predictive of admission vary based on the population to which the ED served (i.e., children only, or both adults and children). This study aimed to describe the profile and identify factors predictive of hospital admission for children who presented to four EDs in Australia and one ED in Sweden. Methods A multi-site observational cross-sectional study using routinely collected data pertaining to ED presentations made by children < 18 years of age between July 1, 2011 and October 31, 2012. Univariate and multivariate analysis were undertaken to determine factors predictive of hospital admission. Results Of the 151,647 ED presentations made during the study period, 22% resulted in hospital admission. Admission rate varied by site; the children’s EDs in Australia had higher admission rates (South Australia: 26%, Queensland: 23%) than the mixed (adult and children’s) EDs (South Australia: 13%, Queensland: 17%, Sweden: 18%). Factors most predictive of hospital admission for children, after controlling for triage category, included hospital type (children’s only) adjusted odds ratio (aOR):2.3 (95%CI: 2.2–2.4), arrival by ambulance aOR:2.8 (95%CI: 2.7–2.9), referral from primary health aOR:1.5 (95%CI: 1.4–1.6) and presentation with a respiratory or gastrointestinal condition (aOR:2.6, 95%CI: 2.5–2.8 and aOR:1.5, 95%CI: 1.4–1.6, respectively). Predictors were similar when each site was considered separately. Conclusions Although the characteristics of children varied by site, factors predictive of hospital admission were mostly similar. The awareness of these factors predicting the need for hospital admission can support the development of clinical pathways.https://doi.org/10.1186/s12913-023-09403-wEmergency departmentsChildrenHospital admissionAustraliaSweden |
| spellingShingle | Julia Crilly Amy Sweeny Åsa Muntlin David Green Lorelle Malyon Luke Christofis Malcolm Higgins Ann-Sofie Källberg Sara Dellner Åsa Myrelid Therese Djärv Katarina E. Göransson Factors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional study BMC Health Services Research Emergency departments Children Hospital admission Australia Sweden |
| title | Factors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional study |
| title_full | Factors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional study |
| title_fullStr | Factors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional study |
| title_full_unstemmed | Factors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional study |
| title_short | Factors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional study |
| title_sort | factors predictive of hospital admission for children via emergency departments in australia and sweden an observational cross sectional study |
| topic | Emergency departments Children Hospital admission Australia Sweden |
| url | https://doi.org/10.1186/s12913-023-09403-w |
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