Defining criteria and resource use for high dependency care in children: an observational economic study. Issue 7 (31st March 2014)

• Record Type: Journal Article
• Authors: Morris, Kevin P; Oppong, Raymond; Holdback, Nicola; Coast, Joanna
• Other Names: Holdback Nicola author non-byline.; Morris Kevin author non-byline.; Alexander John author non-byline.; Coast Joanna author non-byline.; Oppong Raymond author non-byline.; Whitehouse David author non-byline.; Heward Yvonne author non-byline.; Timmins Chris author non-byline.; Wilson Phil author non-byline.; Duncan Heather author non-byline.; Reynolds Fiona author non-byline.; Wacogne Ian author non-byline.; Van Mourik Indra author non-byline.; Cox Helen author non-byline.; Hobin David author non-byline.; Meehlhause Mary author non-byline.; Darbyshire Phil author non-byline.; Hotchin Jacky author non-byline.; Wacogne Ian author non-byline.; Dodson Emma author non-byline.; Plaza Michelle author non-byline.; Milford David author non-byline.; O'Reilly Lorraine author non-byline.; Barron David author non-byline.; Dhillon Rami author non-byline.; Dawson Tracey author non-byline.; Clinton Jackie author non-byline.; Kay Andrew author non-byline.; Murtaza Alia author non-byline.; Lander Tony author non-byline.; Cossey Julie author non-byline.; Ninan Titus author non-byline.; Whyte Caroline author non-byline.; Agwu Chizo author non-byline.; Makwana Niten author non-byline.; Bennett Heather author non-byline.; Nanra Avnash author non-byline.; Haywood Joy author non-byline.; Duflot Paul author non-byline.; Lephalala Rasekhuta author non-byline.; Dison Penny author non-byline.; Coan David author non-byline.; Allen Karen author non-byline.; Simmonds Edward author non-byline.; Pritchard Leah author non-byline.; Sanderson Angela author non-byline.; Alexander John author non-byline.; Whitehurst Caroline author non-byline.; Burt Rose author non-byline.; Scanlon John author non-byline.; Haley Karen author non-byline.; Bates Cheryl author non-byline.; Thorne Christopher author non-byline.; Walker Sara author non-byline.; Greaves Lea-ann author non-byline.; Colley Jane author non-byline.; Irving Melanie author non-byline.; Deol Priya author non-byline.; Panchal Reena author non-byline.; Sinclair Helen author non-byline.; Perkins Louise author non-byline.; Plant Gemma author non-byline.; Moore Shelly author non-byline.; Davies Hayley author non-byline.; Purcell Alex author non-byline.; Forrest Sarah author non-byline.;
• Is Part Of: Archives of disease in childhood. Volume 99:Issue 7(2014)
• Page Start: 652
• Page End: 658
• Publication Date: 2014-03-31
• Subjects: Nursing Care -- Costing -- Data Collection -- Epidemiology -- Health services research; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2013-305133
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Objectives: Internationally there is no consensus on defining and funding of paediatric high dependency care (HDC). This study tested whether a new UK Healthcare Resource Group (HRG) classification for HDC, with two categories of basic and advanced HDC, can identify children who consume greater staff resource. It also explored the impact of a change in basic HDC HRG criteria introduced in April 2011. Design: Observational study of medical and nursing staff resource use. Setting: 16 paediatric wards across 6 regional hospitals; 1 tertiary children's hospital (November 2010 to March 2011). Participants: 1098 infants and children admitted to paediatric wards. Main outcome measures: Number of children meeting criteria for basic and advanced HDC HRGs; care in a cubicle; medical and nursing staff costs, extrapolated from time spent at patient bedside. Results: 223 (20.3%) children met original HDC criteria (15.9% basic, 4.4% advanced). This fell to 88 (8.0%) with the change in basic HDC definition (3.6% basic, 4.4% advanced). Children who met original HDC criteria consumed greater bedside staff resource than those not meeting criteria (cost ratio 1.0:1.75:2.96 (non-HDC:basic HDC:advanced HDC)), with revised criteria identifying a (smaller) basic group with greater staff resource use (cost ratio 1.0:2.35:2.76). Being cared for in a cubicle was not associated with greater staff costs. Conclusions: HDC HRG criteria identify children who consume significantly greater staff resources. Revision of the definition has resulted in a large reduction of cases meeting the criteria but identifies a group consuming greater staff resources.