Contact with the National Health Service in the week after an acute medical paediatric admission.

Abstract

Introduction: After a child is discharged home following an emergency admission to hospital, little is known about contact with emergency departments (ED) or out-of-hours (OOH) general practice. Here, we report the number of contacts with ED and OOH in the week after discharge from hospital in Scotland during 2015-2017, including the number of contacts which result in a readmission.

Methods: Databases containing routinely collected details from hospital admissions for an acute medical condition and subsequent presentation to ED or OOH were linked using a unique personal identifier and the date of discharge.

Results: Of 171 039 urgent admissions, the source of referral was identified for 97 177 (57%) including 92 148 referred by ED or OOH. In the week following discharge, 11 025 (11%) children had a total of 11 497 contacts with ED and/or OOH. The daily number of contacts with ED and/or OOH fell from 2560 on the day after discharge to 1008 1 week after discharge. There were 3892 (35%) children readmitted following contact with ED and/or OOH. An additional 7133 children had a total of 7605 contacts with ED and/or OOH in the week postdischarge but were not readmitted.

Conclusion: Many families seek medical assistance for their child from ED and/or OOH in the week after discharge from hospital, and the majority are not managed by or referred back to paediatric services. Clearer discharge planning could reduce the burden on ED, OOH and parents.