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. 2018 Dec 20;18(1):390.
doi: 10.1186/s12887-018-1360-z.

Hospitalisation after birth of infants: cross sectional analysis of potentially avoidable admissions across England using hospital episode statistics

Eleanor Jones  1 , Beck Taylor  2 , Gavin Rudge  2 , Christine MacArthur  2 , Deepthi Jyothish  3 , Doug Simkiss  4 , Carole Cummins  2
Affiliations

Hospitalisation after birth of infants: cross sectional analysis of potentially avoidable admissions across England using hospital episode statistics

Eleanor Jones et al. BMC Pediatr. .

Abstract

Background: Admissions of infants in England have increased substantially but there is little evidence whether this is across the first year or predominately in neonates; and for all or for specific causes. We aimed to characterise this increase, especially those admissions that may be avoidable in the context of postnatal care provision.

Methods: A cross sectional analysis of 1,387,677 infants up to age one admitted to English hospitals between April 2008 and April 2014 using Hospital Episode Statistics and live birth denominators for England from Office for National Statistics. Potentially avoidable conditions were defined through a staged process with a panel.

Results: The rate of hospital admission in the first year of life for physiological jaundice, feeding difficulties and gastroenteritis, the three conditions identified as potentially preventable in the context of postnatal care provision, increased by 39% (39.55 to 55.33 per 1000 live births) relative to an overall increase of 6% (334.97 to 354.55 per 1000 live births). Over the first year the biggest increase in admissions occurred in the first 0-6 days (RR 1.26, 95% CI 1.24 to 1.29) and 85% of the increase (12.36 to 18.23 per 1000 live births) in this period was for the three potentially preventable conditions.

Conclusions: Most of the increase in infant hospital admissions was in the early neonatal period, the great majority being accounted for by three potentially avoidable conditions especially jaundice and feeding difficulties. This may indicate missed opportunities within the postnatal care pathway and given the enormous NHS cost and parental distress from hospital admission of infants, requires urgent attention.

Keywords: Avoidable readmission; Infant admission; Postnatal care.

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Conflict of interest statement

Ethics approval and consent to participate

An application to HSCIC to hold a national extract of admitted patient care data was approved by the Data Access Advisory Group at the Health and Social Care Information Centre. A self-assessment form was submitted to University of Birmingham Ethics Committee indicating that access to the data had been granted.

Consent for publication

N/A

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Process for identifying potentially avoidable admissions and development of the coding framework
Fig. 2
Fig. 2
Age specific infant hospital admission rates in England per 1000 live births by year of birth 2008/09 to 2013/14
See this image and copyright information in PMC

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