This briefing uses evidence from hospital data over the 10-year period from 2009/10 to 2018/19 to look at the increase in emergency admissions for young children, aged under five, and to explore some of the possible underlying reasons for the increase. It also sets out recommendations for policy-makers, researchers, data providers and data users in light of this analysis, and considers the implications in the context of the Covid-19 pandemic and beyond.
- The growth in short-stay emergency admission rates over the 10-year period was largest for infants and was focused among the very young, with the rate for infants aged one to six days increasing by 109%, from 11 to 23 per 1,000 population. There were associated large increases in short-stay emergency admission rates for conditions such as neonatal jaundice, which can be preventable and which targeted interventions might help.
- We found high rates of short-stay emergency admissions among children from the most deprived areas of England and a persistent gap between children from the most deprived areas and those from the least deprived areas. These need to be addressed. Some regions do not have a deprivation gap at all, or they have narrowed it over time, and research is needed to understand what is different about these areas.
- We found that the existing national hospital datasets are not effectively capturing short-stay emergency activity for young children. There is no way to identify observation activity that might occur in paediatric assessment units rather than on the ward or in the emergency department. The absence of a time measure for admission and discharge in inpatient data means that separating short-stay emergency activity from other forms of care is challenging.
- Differences in service provision could be influencing emergency admission rates both across England and over time. We found differences in short-stay emergency admission rates between hospitals depending on the type of short-stay assessment unit they had for young children. We also know from research by others that the opening of a paediatric assessment unit can lead to changes in the volume of emergency admissions to the ward.