Child Health

Statistical Publication Notice

25 March 2008

Childhood Hospital Admissions & Mortality

CHILDHOOD HOSPITAL ADMISSIONS

INTRODUCTION

Children may be admitted to an acute hospital for a number of reasons including specialist diagnostic procedures, emergency treatment following accidents and routine, complex and life-saving surgery.

In some instances the admission will be planned (known as elective admissions) and in some cases unplanned (emergency admissions). Children may be admitted to hospital as a planned day case where the patient does not remain overnight or as an inpatient (where they stay overnight).

This release includes, for 2006/07, annual information on acute hospital admissions for children under 15 years of age and a summary of diagnoses and procedures / operations carried out. Note that ‘acute’ hospital care excludes obstetric and psychiatric services.

KEY POINTS

In children under 15 years of age, emergency admissions are more common than planned admissions (around 57,000 and 40,000 admissions respectively in 2006/07).
Children under the age of one year have the highest admission rate, largely attributable to emergency admissions.
The most common main diagnoses for emergency admissions were ‘Respiratory Disorders’ (23.0%). For planned admissions ‘Disorders of teeth, tongue and mouth’ were the most common main diagnoses (24.2%); this is largely attributable to dental caries.

DETAILED FINDINGS

In children under 15 years of age, emergency admissions are more common than planned admissions (the reverse is true for adults). During 2006/07, the emergency admission rate was 66.2 per 1,000 population (57,274 admissions) in comparison to the planned admission rate of 46.0 per 1,000 population (39,820 admissions).
Children under the age of one year have the highest admission rate, largely attributable to emergency admissions (240.5 per 1,000 population).
For children under the age of 15 years, the three most common main diagnoses for planned admissions in 2006/07 were: 'Disorders of teeth, tongue and mouth' (24.2%), which is largely attributable to dental caries, 'Congenital anomalies' (10.4%) and 'Neoplastic disease' (9.9%).
For children under the age of 15 years, admitted as an emergency, the three most common diagnoses in 2006/07 were: 'Respiratory disorders' (23.0%), 'Symptoms and signs without a definitive diagnosis' (21.1%) and 'Injuries and poisonings' (17.7%).
In 2006/07 just over 35,000 planned operations/procedures were carried out for children aged under 15 and over a quarter (27%) were for operations on their teeth including simple extractions. This is particularly noticeable for children in the 1-4 and 5-9 year age groups with rates of 10.1 and 19.7 per 1,000 population, respectively.
Tonsil and adenoid operations are also commonly performed on children and account for 7.2% of all main procedures for planned admissions. This is most evident in the 5-9 year age group (3.9 per 1,000 population).

CHILD MORTALITY

INTRODUCTION

Death in childhood is rare and rates have fallen significantly during the 20th century. Some factors which have contributed to this decline are improved diet, sanitation and health care as well as wider availability of vaccinations and better access to ante- and post-natal care.

A summary of mortality in children under 15 years of age for 2006 is presented, from previously published death registration data collected by the General Register Office for Scotland (GROS).

KEY POINTS

Death rates in children under 15 years have halved since 1986.
Although death in childhood is rare, mortality rates are highest amongst children under the age of one year. Most of these deaths occur in the first few days after birth.

DETAILED FINDINGS

Death rates in children under 15 years have fallen from 8.5 per 10,000 population (830 deaths) in 1986 to 4.2 per 10,000 population (362 deaths) in 2006.
Although death in childhood is rare, mortality rates are highest amongst children under the age of one year, with a rate of 45.0 per 10,000 population; this represents approximately two thirds of all deaths in children under 15 years of age (248 out of 362).
The main causes of death in childhood are perinatal conditions (139 deaths). These are conditions occurring in the first week of life such as disorders relating to prematurity and respiratory and cardiovascular disorders. The second most common causes of death are congenital anomalies (73 deaths). These two primary causes of death account for over half (58%) of deaths in children under 15 years old and demonstrate that pregnancy and birth can be hazardous periods of development.

For further information on perinatal conditions, please see the
Scottish Perinatal and Infant Mortality and Morbidity Report (SPIMMR)

Children from the most deprived areas have a higher mortality rate than children from the most affluent areas. In 2006, 6.0 deaths per 10,000 population were recorded in the most deprived areas compared with 2.4 deaths per 10,000 in the least deprived areas.

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MAIN CONTACTS:

Dr Jim Chalmers (Consultant in Public Health Medicine)
Head of Programme
Women and Children's Health Information Programme
Tel : 0131 275 6136
Jim.Chalmers@isd.csa.scot.nhs.uk

Judith Tait
Child Health Team Information Manager
Tel: 0131 275 6833
Judith.Tait@isd.csa.scot.nhs.uk

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GLOSSARY:

Elective (planned) - this is also referred to as a waiting list admission. An elective admission occurs when a patient is on an inpatient or day case waiting list and is admitted to hospital as planned.

Emergency - this is a serious occurrence that happens unexpectedly and demands immediate action. The patient may or may not be admitted through Accident and Emergency.

Inpatient - an inpatient is a patient who occupies an available staffed bed in a hospital and remains overnight whatever the original intention OR - at admission, is expected to remain overnight but is discharged earlier.

Day case - a day case is a patient who makes a planned attendance and requires the use of a bed or trolley in lieu of a bed. The patient is not expected to, and does not, remain overnight.

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