Patterns of admissions for children with special needs to the paediatric assessment unit.
BACKGROUND
Children with special needs present a challenge to those involved in their care.


OBJECTIVE
To determine the role of the acute assessment unit for these children.


METHODS
Case notes and other records were reviewed for information on referrals, admissions, readmission within 7 and 28 days, length of stay, and management of 86 children registered for special needs. The study covered five years between January 1997 and December 2001.


RESULTS
Of the 86 children, 48 (58%) were boys; 62 children had cerebral palsy and 52 learning disability. There were 914 episodes, with 44% of these being self referrals and 35% from general practitioners; 35.5% of the episodes were managed in the assessment unit. The average length of stay in hospital was 5 days, ranging from <24 hours to 63 days; 37.5% of those admitted to the ward stayed for less than 24 hours. Respiratory tract infections and seizures were the main reasons for referral and admission.


CONCLUSIONS
Children with special needs tend to have a predictable pattern of conditions requiring inpatient care. One third of the inpatients episodes did not need a prolonged stay in hospital. This latter group of children could be managed at home with support of community nurses. Integrated care pathways need to be developed to minimise disruption to their lives. Appropriate resources should be made available to achieve these goals.
Mahon
M
M
Department of Paediatrics, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK. Mohammed.kibirige@stees.nhs.uk
Kibirige
M S
MS
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008607:Intellectual Disability / Q000150:complications*; D007902:Length of Stay; D008297:Male; D010372:Pediatrics; D011320:Primary Health Care; D012017:Referral and Consultation; D012141:Respiratory Tract Infections / Q000150:complications* / Q000628:therapy; D012189:Retrospective Studies; D012640:Seizures / Q000150:complications* / Q000628:therapy