title: Tertiary paediatric hospital admissions in children and young people with cerebral palsy.
abstract: BACKGROUND
  Many previous studies that have investigated hospital admissions in children and young people with cerebral palsy lack information on cerebral palsy severity and complexity. Consequently, little is known about factors associated with the frequency and type of hospital admissions in this population. This study used hospital admission data available for all children and young people known to a population-based cerebral palsy register to describe the patterns of use of tertiary paediatric hospital services over a 5-year period.
  
  
  METHODS
  This was a retrospective cohort analysis of routinely collected admission data from the two tertiary paediatric hospitals in the Australian state of Victoria. Data on admissions of individuals born between 1993 and 2008 registered on the Victorian Cerebral Palsy Register were analysed (n = 2183).
  
  
  RESULTS
  Between 2008 and 2012, 53% of the cohort (n = 1160) had at least one same-day admission, and 46% (n = 996) had one or more multi-day admissions. Those with a moderate to severe motor impairment and those with a co-diagnosis of epilepsy had more admissions, and for multi-day admissions, longer lengths of stay, P < 0.05. Across all severity levels, respiratory and musculoskeletal diseases were the most frequently reported reasons for medical and surgical admissions, respectively. All-cause readmission rates for urgent multi-day stays within 7, 30 and 365 days of an index admission were 10%, 23% and 63%, respectively.
  
  
  CONCLUSIONS
  The reasons for hospital admissions reported here reflect the range of comorbidities experienced by children and young people with cerebral palsy. This study highlights priority areas for prevention, early diagnosis and medical management in this group. Improved primary and secondary prevention measures may decrease non-elective hospital admissions and readmissions in this group and reduce paediatric inpatient resource use and healthcare expenditure attributable to cerebral palsy.
authors.affiliation: Department of Paediatrics, University of Melbourne, Melbourne, Australia.|Developmental Disability and Rehabilitation Research, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Meehan
authors.affiliation: Health Systems and Workforce Unit, Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, Australia.
authors.forename: G L
authors.initials: GL
authors.lastname: Freed
authors.affiliation: Department of Paediatrics, University of Melbourne, Melbourne, Australia.|Developmental Disability and Rehabilitation Research, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia.
authors.forename: S M
authors.initials: SM
authors.lastname: Reid
authors.affiliation: Department of Paediatrics, University of Melbourne, Melbourne, Australia.|Developmental Disability and Rehabilitation Research, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia.|Developmental Medicine, Royal Children's Hospital, Melbourne, Australia.|Deakin Child Study Centre, School of Psychology, Deakin University, Melbourne, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Williams
authors.affiliation: Department of Paediatrics, University of Melbourne, Melbourne, Australia.|Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia.|Community Health Services Research, Population Health, Murdoch Childrens Research Institute, Melbourne, Australia.
authors.forename: J R
authors.initials: JR
authors.lastname: Sewell
authors.affiliation: Paediatric Rehabilitation, Monash Children's Hospital, Melbourne, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Rawicki
authors.affiliation: Department of Paediatrics, University of Melbourne, Melbourne, Australia.|Developmental Disability and Rehabilitation Research, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia.|Developmental Medicine, Royal Children's Hospital, Melbourne, Australia.
authors.forename: D S
authors.initials: DS
authors.lastname: Reddihough
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D006760:Hospitalization / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D012042:Registries; D012120:Respiration Disorders / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
keywords: cerebral palsy register; health services research; hospitalisations; inpatient resources; readmissions; respiratory