Aim To investigate whether children living near paediatric emergency departments have lower paediatric admission rates than children living near general emergency departments.
Design (i) Descriptive analysis of paediatric admissions using routine hospital episode statistics data (HES data). (ii) Spatial analysis of paediatric and general emergency departments and census output areas using Geographical Information Systems.
Subjects All paediatric emergency admissions of 0–14 year olds in the financial years 2001/2002 –2005/2006 in all hospitals in England.
Hypothesis Null (H0): there is no difference in paediatric admission rates between children living near paediatric emergency departments and children living near general emergency departments. (H1): children living near paediatric emergency departments are less likely to be admitted than populations of children living near general emergency departments.
Main outcome measures RRs of admission with adjustment for age, sex, deprivation and year of admission, both overall and for specific disease categories: asthma, respiratory diseases, gastroenteritis, other infections, signs and symptoms, injuries and other admissions.
Results There were 3 156 479 admissions over the 5-year period. Children living near paediatric emergency departments have a lower risk of admission (RR 0.77, 95% CI 0.76 to 0.77) compared with children living nearby general emergency departments. The highest admission rates came from the most deprived areas (Carstairs 5) and the lowest from the least deprived (Carstairs 1). Boys had higher admission rates than girls for all diagnoses and the under-1s had the highest admission rates followed by the 10–14 year olds.
Conclusions Paediatric emergency departments may have a significant impact in reducing childhood admissions.
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