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'Failure in primary care services' blamed for rise in child hospital admissions

By Lilian Anekwe

Hospital admissions in children have ‘increased substantially' over recent years, with a sharper rise since GPs opted out of out-of-hours, new research has found.

Short stay admissions in children rose by 41% in the ten years between 1997 and 2006, the study found, with a ‘sharper rise' observed after the opt-out in 2004, which the researchers said was linked to a shortfall in out-of-hours primary care services – but insisted further research is needed before this could be unequivocally proven.

The study analysed hospital episode statistics for overall unplanned short stay admissions in 4.8 million children aged less than ten years from 1997 and 2006. Over this period annual unplanned admission rates in children rose by 22%, from 74 to 86 per 1,000.

An even larger increase of 41% was seen in short stay admissions, which rose from 43 to 60 per 1,000. Unplanned readmission rates also rose by 37%, although this accounted for less than 10% of total admissions. Meanwhile admissions of more than two days duration fell by 12% fall over the ten year period.

The researchers speculated that several other changes imposed in 2004 may also have contributed to the rise in unplanned admissions. Reductions in the working hours of junior doctors leading to more inexperience frontline staff, and more stringent waiting time targets, could lead to more children being admitted.

Lead author, Dr Sonia Saxena, a GP in Putney and senior clinical lecturer in primary care at Imperial College, concluded in the journal PLoS One: ‘Short stay unplanned hospital admission rates in young children in England have increased substantially in recent years and are not accounted for by reductions in length of in-hospital stay.'

‘The majority are isolated short stay admissions for minor illness episodes that could be better managed by primary care in the community and may be evidence of a failure of primary care services.'

She told Pulse: ‘There has been a sharper rise post 2004, particularly in the under ones. We expect that the trend is going to continue. There has not been anything put in place to absorb the slack. It's going to cost the NHS a lot of money and may well put children at risk of harm.'

Hospital admissions in children have risen since the out-of-hours opt-out in 2004, the study found Hospital admissions in children have risen since the out-of-hours opt-out in 2004, the study found

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