A prospective cohort study comparing hospital admission for gastro-enteritis with home management.
OBJECTIVE
To compare physical and psychological outcomes in children presenting at Accident and Emergency Departments (A&E), diagnosed with gastro-enteritis and admitted to hospital with those of a similar age, sex and severity of illness discharged home. The physical and psychological well-being of children in these two groups, in the month after the episode, were compared as was further use of health care services.


METHODS
A prospective cohort study.


METHODS
A comparison of 116 children aged 1-6 years with gastro-enteritis, presenting at A&E over a 6 months period. Admitted children were compared with children discharged, of a similar age, sex and illness severity (triage score) with follow-up at 1 week and 1 month. Clinical history, psychosocial factors, investigations and outcomes were recorded at presentation and physical, psychological and family outcomes at 1 week and 1 month.


RESULTS
Of 116 children, 112 (97%) completed the study (56 in each group). No differences were detected in psychosocial factors, socio-economic status, family factors, time of arrival at A&E or waiting times. Parental perception of illness was greater in the admitted group (P < 0.005), but was recorded after the decision on admission was made. At 1 week follow-up admitted children had increased separation anxiety compared with children who were discharged (P < 0.05), but this difference disappeared at 1 month. Clinical outcomes were the same for both groups, although admitted children had more investigations (91% vs. 39%). Parents were equally satisfied with their child's treatment, but one-third of children in both groups sought further consultation with a health professional in the following week.


CONCLUSIONS
There is no statistically significant difference in socio-demographic data, time of arrival at A&E, waiting times, clinical and psychosocial outcomes in children with acute gastro-enteritis admitted to hospital compared with a group of children of similar age, gender and severity of illness managed at home. However, parents seek reassurance and follow-up of acutely ill children, even if the child is admitted to hospital, which has service and resource implications.
Small
F
F
Department of Child Health, The Queen's University of Belfast, UK.
Alderdice
F
F
McCusker
C
C
Stevenson
M
M
Stewart
M
M
D002648:Child; D002652:Child Behavior / Q000523:psychology; D002675:Child, Preschool; D004630:Emergencies; D005260:Female; D005759:Gastroenteritis / Q000628:therapy*; D006699:Home Care Services / Q000458:organization & administration*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents / Q000523:psychology; D017060:Patient Satisfaction; D011446:Prospective Studies; D012017:Referral and Consultation; D016896:Treatment Outcome