Premium
A prospective cohort study comparing hospital admission for gastro‐enteritis with home management
Author(s) -
Small F.,
Alderdice F.,
McCusker C.,
Stevenson M.,
Stewart M.
Publication year - 2005
Publication title -
child: care, health and development
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.832
H-Index - 82
eISSN - 1365-2214
pISSN - 0305-1862
DOI - 10.1111/j.1365-2214.2005.00550.x
Subject(s) - medicine , psychosocial , prospective cohort study , triage , anxiety , cohort , pediatrics , emergency department , cohort study , emergency medicine , psychiatry
Objectives 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. Design 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.