PART 3: CHILDREN'S OUTCOMES - HEALTH

Chronic Health Conditions and Hospitalisation

Being in hospital can be a distressing and difficult situation for children, losing contact with friends and siblings, missing home and schooling, and losing freedom and privacy 31, as well as financial strain on the family 32

Measure

The principal conditions resulting in hospitalisation among children.

Key findings

  • In 2007, there were 144,703 hospital discharges among children, aged 0-17 (see Table 48).

Table 48: Hospitalisation of children, by gender and age (2007)

Age Boys Girls Total
<1 year 17,488 13,924 31,412
1-4 years 24,884 17,734 42,618
5-9 years 16,058 12,119 28,177
10-14 years 12,659 10,157 22,816
15-17 years 9,626 10,054 19,680
Total 80,715 63,988 144,703

Source: Hospital In-Patient Enquiry, ESRI

Differences by age and social class
Of these hospital discharges:

  • 21.7% (31,412) were in the under-1-year age group; 29.5% (42,618) were in the 1-4 age group; 19.5% (28,177) were in the 5-9 age group; 15.8% (22,816) were in the 10-14 age group; and 13.6% (19,680) were in the 15-17 age group.
  • 55.8% (80,715) were boys and 44.2% (63,988) were girls.

Table 49: Hospitalisation of children, by principal diagnosis and age (2007)

  <1 year 1-4 years 5-9 years 10-14 years 15-17 years Total
Conditions No. % No. % No. % No. % No. % No. %
Diseases of the respiratory system 4,571 14.6 8,160 19.1 3,668 13.0 1,914 8.4 1,577 8.0 19,890 13.7
Injury, poisoning and certain other consequences of external causes 895 2.8 4,235 9.9 3,629 12.9 3,454 15.1 2,887 14.7 15,100 10.4
Certain infectious and parasitic diseases 3,849 12.3 5,881 13.8 1,849 6.6 1,017 4.5 583 3.0 13,179 9.1
Diseases of the digestive system 1,320 4.2 2,481 5.8 3,983 14.1 2,876 12.6 2,148 10.9 12,808 8.9
Certain conditions originating in the perinatal period 9,099 29.0 38 0.1 3 0.0 1 0.0 0 0.0 9,141 6.3
Congenital malformations, deformations and chromosomal abnormalities 3,416 10.9 3,051 7.2 1,173 4.2 728 3.2 316 1.6 8,684 6.0
Diseases of the genito-urinary system 1,373 4.4 2,879 6.8 1,579 5.6 881 3.9 904 4.6 7,616 5.3
Neoplasms 210 0.7 1,752 4.1 1,608 5.7 1,315 5.8 1,153 5.9 6,038 4.2
Diseases of the ear and mastoid process 225 0.7 2,078 4.9 1,461 5.2 659 2.9 297 1.5 4,720 3.3
Diseases of the skin and subcutaneous tissue 358 1.1 714 1.7 503 1.8 1,093 4.8 1,425 7.2 4,093 2.8
Diseases of the musculoskeletal system and connective tissue 70 0.2 742 1.7 820 2.9 1,106 4.8 792 4.0 3,530 2.4
Endocrine, nutritional and metabolic diseases 345 1.1 625 1.5 803 2.8 1,044 4.6 528 2.7 3,345 2.3
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism 195 0.6 1,090 2.6 937 3.3 631 2.8 388 2.0 3,241 2.2
Diseases of the nervous system 257 0.8 764 1.8 589 2.1 568 2.5 414 2.1 2,592 1.8
Diseases of the eye and adnexa 125 0.4 554 1.3 457 1.6 277 1.2 183 0.9 1,596 1.1
Pregnancy, childbirth and the puerperium 0 0.0 0 0.0 0 0.0 21 0.1 1,425 7.2 1,446 1.0
Diseases of the circulatory system 120 0.4 160 0.4 324 1.1 331 1.5 275 1.4 1,210 0.8
Mental and behavioural disorders 6 0.0 117 0.3 91 0.3 284 1.2 241 1.2 739 0.5
All other conditions and reasons for admission* 4,978 15.8 7,297 17.1 4,700 16.7 4,616 20.2 4,144 21.1 25,735 17.8
Total 31,412 100.0 42,618 100.0 28,177 100.0 22,816 100.0 19,680 100.0 144,703 100.0

* This category includes symptoms, signs and abnormal findings (not elsewhere classified) and factors influencing health status and contact with health services.

Source:Hospital In-Patient Enquiry, ESRI

  • The total number of hospital discharges among children aged 0-17 increased by 8,733 between 2003 and 2007 (see Table 50).

Table 50: Hospitalisation of children, by age (2003-2007)

  2003 2004 2005 2006 2007
Age No. % No. % No. % No. % No. %
<1 year 26,840 19.7 29,288 20.8 30,283 21.3 31,687 21.7 31,412 21.7
1-4 years 39,382 29.0 40,419 28.8 42,154 29.6 43,662 29.9 42,618 29.5
5-9 years 26,736 19.7 28,776 20.5 28,079 19.7 28,717 19.6 28,177 19.5
10-14 years 23,803 17.5 23,295 16.6 23,564 16.6 23,396 16.0 22,816 15.8
15-17 years 19,209 14.1 18,750 13.3 18,165 12.8 18,725 12.8 19,680 13.6
Total 135,970 100.0 140,528 100.0 142,245 100.0 146,187 100.0 144,703 100.0

  • 15,100 hospital discharges among children had a diagnosis of external cause of injury and poisoning. 62.7% (9,472) of these children were boys (see Table 51).
  • 39.5% and 11.6% hospital discharges among children had diagnoses of external cause of injury and poisoning arising from accidental falls and transport accidents respectively (see Figure 19).
  • 59.7% (271) hospital discharges with a diagnosis of external cause of injury arising from accidental poisonings were among children aged 1-4.
  • 77.3% (272) hospital discharges with a diagnosis of external cause of injury arising from intentional self-harm were among children aged 15-17.

Figure 19: Hospitalisation of children with a diagnosis of external cause of injury arising from a transport accident, by age (2007)

fig19

Source: Hospital In-Patient Enquiry, ESRI

Table 51: Hospitalisation of children with a diagnosis of external causes of injury and poisoning, by gender and age (2007)

  <1 year 1-4 years 5-9 years 10-14 years 15-17 years Total
  Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total
Accidental falls 289 268 557 1,031 765 1,796 1,002 704 1,706 917 378 1,295 473 143 616 3,712 2,258 5,970
Accidents caused by objects* 44 33 77 537 378 915 403 237 640 392 139 531 317 58 375 1,693 845 2,538
Transport accidents 10 12 22 152 92 244 267 204 471 343 213 556 295 169 464 1,067 690 1,757
Drowning, submersion, other accidental threats to breathing and foreign bodies 17 16 33 130 126 256 117 80 197 43 16 59 18 8 26 325 246 571
Accident, not otherwise specified 11 10 21 45 20 65 36 30 66 83 23 106 224 45 269 399 128 527
Accidental poisoning 9 15 24 159 112 271 24 20 44 38 27 65 26 24 50 256 198 454
Intentional self-harm 0 0 0 0 0 0 0 0 0 19 61 80 74 198 272 93 259 352
Assault 6 8 14 7 2 9 7 1 8 60 9 69 190 25 215 270 45 315
Contact with heat or hot substances 23 22 45 118 88 206 9 16 25 5 3 8 1 4 5 156 133 289
Event of undetermined intent 3 3 6 5 5 10 3 2 5 11 25 36 23 25 48 45 60 105
Exposure to smoke, fire and flames 2 2 4 16 7 23 11 2 13 18 3 21 13 0 13 60 14 74
Other external causes of injury 48 38 86 272 149 421 265 171 436 397 180 577 363 151 514 1,345 689 2,034
External cause not reported 3 3 6 13 6 19 8 10 18 13 38 51 14 6 20 51 63 114
Total 465 430 895 2,485 1,750 4,235 2,152 1,477 3,629 2,339 1,115 3,454 2,031 856 2,887 9,472 5,628 15,100

* Accidents caused by objects include striking against or being struck accidentally by objects or persons; caught accidentally in or between objects; accidents caused by machinery; and accidents caused by cutting/piercing objects.

Note: 'External cause not reported' refers to discharges with a principal diagnosis of 'Injury and Poisoning' and for which an external cause of injury or poisoning was not recorded. The inclusion of this category ensures that the total reported corresponds with the data reported for 'Injury and Poisoning' in Table 51.

Source: Hospital In-Patient Enquiry, ESRI

  • The number of hospital discharges among children with a diagnosis of external cause of injury and poisoning has fallen since 2005 (see Table 52). In particular, there has been a marked decrease in external causes of injury and poisoning arising from transport accidents and intentional self-harm since 2005.

Table 52: Hospitalisation of children with a diagnosis of external causes of injury and poisoning (2005-2007)

  2005 2006 2007
  No. % No. % No. %
Accidental falls 6,107 40.0 6,067 40.7 5,970 39.5
Accidents caused by objects* 2,318 15.2 2,456 16.5 2,538 16.8
Transport accidents 1,944 12.7 1,770 11.9 1,757 11.6
Drowning, submersion, other accidental threats to breathing and foreign bodies 377 2.5 544 3.6 571 3.8
Accident, not otherwise specified 381 2.5 441 3.0 527 3.5
Accidental poisoning 503 3.3 427 2.9 454 3.0
Intentional self-harm 401 2.6 385 2.6 352 2.3
Assault 300 2.0 318 2.1 315 2.1
Contact with heat or hot substances 243 1.6 302 2.0 289 1.9
Event of undetermined intent 114 0.7 103 0.7 105 0.7
Exposure to smoke, fire and flames 64 0.4 113 0.8 74 0.5
Other external causes of injury 1,466 9.6 1,769 11.9 2,034 13.5
External cause not reported 1,038 6.8 210 1.4 114 0.8
Total 15,256 100 14,905 100 15,100 100

* Accidents caused by objects include striking against or being struck accidentally by objects or persons; caught accidentally in or between objects; accidents caused by machinery; and accidents caused by cutting/piercing objects.

Note: 'External cause not reported' refers to discharges with a principal diagnosis of 'Injury and Poisoning' and for which an external cause of injury or poisoning was not recorded. The inclusion of this category ensures that the total reported corresponds with the data reported for 'Injury and Poisoning' in Table 51.

Source: Hospital In-Patient Enquiry, ESRI

Technical notes
The Hospital In-Patient Enquiry (HIPE) system, which is managed by the Economic and Social Research Institute (ESRI), provides information on each hospital discharge. HIPE has covered close to 100% of the discharges from publicly funded acute hospitals in recent years.

HIPE data for 1994 to 2004 were classified using ICD-9-CM. All HIPE discharges from 2005 are now coded using ICD-10-AM (the Australian Modification of ICD-10 incorporating the Australian Classification of Health Interventions). This system includes significant changes in the classification of diagnoses and procedures. This means that it is not possible to directly compare the data published for 2005-2007 in this report to previously reported data for 1994-2004. For more information on the introduction of ICD-10-AM, see http://www.esri.ie/health_information/hipe/clinical_coding/icd10am/

Care must be taken not to use hospitalisation rates as a proxy for incidence or prevalence of ill-health in children. Rates are based on episodes of care such that an individual case will be counted separately in the statistics for each admission to hospital. In addition, hospital data will reflect changes in treatment protocols, as well as issues of access to care.

 

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31 Coyne, I., Hayes, E., Gallagher, P. and Regan, G. (2006) Giving Children a Voice: An investigation of children's experiences of participation in consultation and decision-making within the Irish healthcare setting, National Children's Office. Dublin: The Stationery Office. Available at: www.childrensdatabase.ie OR www.omc.gov.ie

32 Fitzgerald, E. (2004) Sick Children, Money Worries: The financial cost of a child in hospital. Dublin: Children in Hospital Ireland.