scholarly journals Are active children and young people at increased risk of injuries resulting in hospital admission or accident and emergency department attendance? Analysis of linked cohort and electronic hospital records in Wales and Scotland

PLoS ONE ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. e0213435
Author(s):  
Lucy J. Griffiths ◽  
Mario Cortina-Borja ◽  
Karen Tingay ◽  
Amrita Bandyopadhyay ◽  
Ashley Akbari ◽  
...  
Keyword(s):  
Emergency Department ◽  
Young People ◽  
Hospital Admission ◽  
Hospital Records ◽  
Children And Young People ◽  
Emergency Department Attendance ◽  
Accident And Emergency ◽  
Increased Risk ◽  
Accident And Emergency Department ◽  
Electronic Hospital

scholarly journals Predictors of emergency department attendance following NHS 111 calls for children and young people: analysis of linked data

2017 ◽  
Vol 17 (Suppl 3) ◽  
pp. s13-s13
Author(s):  
Cicely Robinson ◽  
Arne Wolters ◽  
Adam Steventon ◽  
Dougal Hargreaves ◽  
Rebecca Pope ◽  
...  
Keyword(s):  
Emergency Department ◽  
Young People ◽  
Linked Data ◽  
Children And Young People ◽  
Emergency Department Attendance

scholarly journals Predictors of emergency department attendance following NHS 111 calls for children and young people: analysis of linked data

2018 ◽  
Author(s):  
Arne Wolters ◽  
Cicely Robinson ◽  
Dougal Hargreaves ◽  
Rebecca Pope ◽  
Ian Maconochie ◽  
...  
Keyword(s):  
Emergency Department ◽  
Young People ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Patient Characteristics ◽  
Health Needs ◽  
Out Of Hours ◽  
Children And Young People ◽  
Emergency Department Attendance ◽  
At Home

ABSTRACTObjectivesTo assess whether clinical input during calls to the NHS 111 telephone-based advice service is associated with lower rates of subsequent emergency department attendance and hospital admission.DesignAlthough NHS 111 largely employs non-clinical call handling staff to triage calls using computerised clinical decision support software, some support is available from clinical supervisors, and additionally some calls are referred to out-of-hours General Practitioners (GP). We used linked data sets to examine GP and secondary care activity following calls to NHS 111, adjusting for the patient characteristics, signs and symptoms recorded during the NHS 111 call.SettingOut-of-hours care in three areas of North West London that have an integrated approach to delivering NHS 111 and out-of-hours GP care.ParticipantsNHS 111 calls for children and young people aged 15 years or under. We excluded calls that were diverted to the emergency (‘999’) service or where patients were advised to go to an emergency department. This left callers who were either referred to a GP or advised to manage their health needs at home.Primary and secondary outcome measuresThe percentage of callers attending any emergency departments, major emergency department, or minor injury unit within ten hours of the NHS 111 call, and the percentage admitted to hospital following visits to emergency departments.ResultsOf the 10,356 callers, 2,898 (28.0%) were advised by NHS 111 to manage their health needs at home, with an appointment with an out-of-hours GP made for the remaining 7,458 (72.0%). 14.9% (432/2,898) of the callers who were advised by NHS 111 to manage their health needs at home attended an emergency department with ten hours, compared with 16% (1,207/7,458) of callers who had an out-of-hours appointment with an out-of-hours GP. After adjusting for patient characteristics, GP out-of-hours appointment was associated with lower rates of emergency department attendance (adjusted odds ratio, 0.86, 95% CI, 0.75-0.99),). When we subset emergency department types, a GP out-of-hours appointment was associated with lower rates of minor injury unit attendance (adjusted odds ratio, 0.32, 95% CI, 0.23 - 0.44) but not major emergency department attendance (adjusted odds ratio 1.06, 95% CI 0.90-1.24). There was no association with hospital admission. Review by an NHS 111 clinical supervisor was associated with fewer emergency department attendances (adjusted OR 0.77, 95% CI, 0.62-0.97).ConclusionsClinical input during or following out-of-hours calls to NHS 111 was associated with lower rates of emergency department utilisation for children and young people, though the reduction may be concentrated in lower intensity care settings. Thus, there may be potential to reduce the use of emergency care by providing access to clinical advice or out-of-hour services in other settings through the NHS 111 telephone service.

scholarly journals Risky presentations

2000 ◽  
Vol 24 (4) ◽  
pp. 137-139
Author(s):  
Fiona Subotsky ◽  
Alistair Santhouse
Keyword(s):  
Emergency Department ◽  
Young People ◽  
Substance Misuse ◽  
Psychosocial Risk ◽  
Clinical Implications ◽  
Information Leaflet ◽  
Older Children ◽  
Accident And Emergency ◽  
Accident And Emergency Department

Aims and MethodsThe aim was to review the assessment and management of the psychosocial risk (including substance misuse) of older children presenting to the accident and emergency department, with a view to making recommendations to improve services. The method used was to inspect casualty records of attendances over two weeks of 11-16-year-olds.ResultsIn no cases was any note made of whether substance misuse might have occurred. Cases of apparent psychosocial risk were, however, dealt with appropriately in the main.Clinical ImplicationsBrief advisory guidelines were written for accident and emergency staff to promote consideration of the misuse of substances in older children, and an information leaflet was developed for young people and their parents.

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