The impact of neurological disorders on hospital admissions for children and young people: a routine health data study

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Stuart William Jarvis John Livingston Anne-Marie Childs Lorna Fraser
Published online: May 17, 2018


Introduction

Neurological conditions are a major and increasing cause of hospitalisation among children and
young people, but little is known about the impact of neurological conditions on hospital services in
England, nor the factors that influence length of stay and bed days per year.


Objectives

To quantify the hospital usage in children and young people related to neurological conditions, trends
over time and variation by ethnicity and deprivation status.


Methods

An ICD10 coding framework identified a cohort of individuals aged 0-19 years with neurological
conditions from linked routinely collected healthcare data from England (The Hospital Episode
Statistics Admitted Patient Care dataset), from 1 April 2003 to 31 March 2015. Linked outpatient
and accident and emergency data were used to supplement missing demographic data. Length of stay
and bed days per year per person were calculated. These were separately modelled using random
intercept multivariable negative binomial regressions with gender, age, ethnic group, diagnostic
group, region of residence and deprivation category as predictors.


Results

524,442 individuals were identified over the study period, increasing from 49,928 in 2003/04 to
102,840 in 2014/15. Neurological conditions account for 8.8% of inpatient bed days in the 0-14
year old age group. Length of stay and bed days per year vary primarily by age group – e.g. Under
1 year olds had 1.85 times (95%CI 1.83-1.86%) longer stays and over double (2.36 times, 95%CI
2.34-2.37 times) the number of bed days per person per year compared to 5 to 9 year olds – and
main diagnostic group, with smaller variations by ethnic group, deprivation and region.


Conclusions

Neurological conditions in children and young people have a significant and increasing impact on the
NHS in England. Falls in length of stay and bed days per person are more than offset by increasing
numbers of children and young people with neurological diagnoses. Variations in length of stay and
bed days per year by diagnostic group, ethnic group, age group, deprivation category and region
should be taken into account in resource planning.


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