title: Rising national prevalence of life-limiting conditions in children in England.
abstract: BACKGROUND
  Life-limiting conditions (LLCs) describe diseases with no reasonable hope of cure that will ultimately be fatal. For children with these diseases, palliative care services should be available but few data are available to estimate the burden of these conditions.
  
  
  METHODS
  Children (0-19 years) with LLCs were identified within an English Hospital Episode Statistics dataset (2000/2001-2009/2010) by applying a customized coding framework of the International Classification of Diseases, 10th Revision, disease codes. Prevalence per 10 000 population (0-19 years) was calculated by age, diagnostic group, ethnicity, deprivation, and region for each year.
  
  
  RESULTS
  The Hospital Episode Statistics extract contained 175 286 individuals with 1 or more LLCs of which congenital anomalies were the most common (31%). Prevalence increased over 10 years from 25 to 32 per 10 000 population. Prevalence in the South Asian (48 per 10 000); black (42 per 10 000); and Chinese, mixed, and "other" (31 per 10 000) populations were statistically significantly higher compared with the white population (27 per 10 000). Prevalence shows an inverse J-shaped relationship with 5 categories of deprivation, with the highest prevalence in the most deprived areas and the lowest in the second least deprived.
  
  
  CONCLUSIONS
  In 2010, the prevalence of LLCs in children in England was double the previously reported estimates and had increased annually in all areas over the past decade. This clearly identifies an escalating need for specialist pediatric palliative care services. When planning services for these increasing needs, the excess prevalence in ethnic minority groups, especially in deprived areas, needs to be considered.
authors.affiliation: Paediatric Epidemiology Group, Division of Epidemiology, University of Leeds, Leeds, UK. l.k.fraser@leeds.ac.uk
authors.forename: Lorna K
authors.initials: LK
authors.lastname: Fraser
authors.forename: Michael
authors.initials: M
authors.lastname: Miller
authors.forename: Richard
authors.initials: R
authors.lastname: Hain
authors.forename: Paul
authors.initials: P
authors.lastname: Norman
authors.forename: Jan
authors.initials: J
authors.lastname: Aldridge
authors.forename: Patricia A
authors.initials: PA
authors.lastname: McKinney
authors.forename: Roger C
authors.initials: RC
authors.lastname: Parslow
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010166:Palliative Care; D015995:Prevalence; D012189:Retrospective Studies; D019452:Terminally Ill / Q000706:statistics & numerical data*; D055815:Young Adult