Child characteristics and health conditions associated with paediatric hospitalisations and length of stay: a population-based study

Francisco J Schneuer; Eleni Demetriou; Diana Bond; Samantha J Lain; Adam J Guastella; Natasha Nassar

doi:10.1016/j.lanwpc.2023.100706

Child characteristics and health conditions associated with paediatric hospitalisations and length of stay: a population-based study

Lancet Reg Health West Pac. 2023 Feb 16:32:100706. doi: 10.1016/j.lanwpc.2023.100706. eCollection 2023 Mar.

Authors

Francisco J Schneuer¹, Eleni Demetriou², Diana Bond¹, Samantha J Lain¹, Adam J Guastella², Natasha Nassar¹

Affiliations

¹ Child Population and Translational Health Research, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Australia.
² Brain and Mind Centre, The Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Australia.

Abstract

Background: Paediatric hospital length of stay (LoS) is often used as a benchmark for resource use of hospitalisations. Previous studies have mostly focused on LoS of admissions for specific conditions or medical specialties. We aimed to conduct an evaluation of LoS of all paediatric hospitalisations exploring the frequency and characteristics; and associated childhood conditions.

Methods: This population-based cross-sectional study included all hospital admissions in children aged <16 years between January 2017 and December 2019 in New South Wales, Australia. LoS was categorised into: day or overnight stay, 2-7, 8-21 and ≥ 22 days. Socio-demographic and health service characteristics of each individual admission by LoS and age groups were evaluated.

Findings: A total of 324,083 children had 518,768 admissions comprising 1,064,032 bed days. Most admissions wereday/overnight stays (71.9%) or 2-7 days (25.3%). While LoS >7 days represented 2.8% of total admissions, they accounted for 27% of total bed days. Children aged 1-4 years had the highest proportion of admissions (35%), with a majority lasting ≤7 days, whereas 45.6% of admissions ≥22 days were for children aged ≥12 years. Respiratory conditions, diseases of the digestive system and traumatic injuries were the most common reasons for hospitalization. LoS >7 days were more common in children from most disadvantaged backgrounds, residing further from hospital and those aged ≥12 years with mental health conditions.

Interpretation: The majority of paediatric hospitalizations are for short stay and require programs that target acute conditions that can be managed in primary care. Interventions such as care coordination, tailored models of care and enhanced outpatient/community treatment programs for high-risk groups will help reduce extended LoS and improving child health and well-being.

Funding: Australian National Health and Medical Research Council.

Keywords: Child health; Health services research; Hospitalisations; Length of stay; Paediatrics.