Abstracts

Rationale: There is urgent need for health systems designed to improve the quality of care and outcomes for the growing number of children with long term or chronic conditions such as epilepsy (Wolfe et al, 2013). For children with epilepsy, hospital admission accounts for the largest proportion of UK National Health Service (NHS) costs (Ali et al, 2014). Information on patterns of hospital utilisation could be used to improve health planning and provision of paediatric epilepsy services. Methods: From an ongoing study, descriptive analyses of routine data collected by the Information Services Division (ISD), NHS National Services Scotland was conducted to investigate hospital admission records between 1981 and 2013 for children and young persons aged less than 18 years. ISD is the repository of national health care datasets used to support health care delivery by the NHS. Patients ever admitted for epilepsy including status epilepticus were identified using primary (main) and secondary diagnoses codes (ICD 9: 345 and ICD 10:G40 and G41). The chi-square test was also used to test for the difference between proportions. Results: Overall, there were 4,153,032 hospital admissions between 1981 and 2013 amongst children aged less than 18 years. The rate of hospital admissions increased from 8615 /100,000 population in 1981 to 12,615/100,000 population in 2012 (based on mid-year population estimates). One fifth of the hospitalisations were of children aged two years or younger (22%); children aged 11years or older made up 31% of the cohort. The hospital admissions for a main or secondary diagnosis of epilepsy comprised 1.54% (n=63,933) of all hospital admissions. For those with a diagnosis of epilepsy admitted to hospital, 12% were infants, 19% aged 2-4 years and 36% aged 10 years or older. Hospital admissions with a diagnosis of status epilepticus made up 0.37% of all hospital admissions and 2.39% of the events amongst children hospitalised with a diagnosis of epilepsy. Trends in hospital admission amongst children with a diagnosis of epilepsy ranged from 1.20% (95% CI: 1.14 - 1.27%) in 1981 to 2.14% (95% CI: 2.1-2.2%) of all hospital admissions in 2013. There was a significant increase in the proportion of children admitted to hospital with a diagnosis of epilepsy in 1981 and 2013 (p<0.001); increasing from 104 hospital admissions/ 100,000 in 1981 to 246 hospital admissions per 100,000 in 2013 amongst children aged less than 18 years. Conclusions: Between 1981 and 2013, hospital admission of children with a diagnosis of epilepsy comprised a small but increasing proportion of all hospital admissions in Scotland. Further research will be done to investigate patterns of hospital admission by age, deprivation and type of admission. References: Wolfe I, Gill P, Thompson et al. Health services for children in western Europe. Lancet 2013; 381:1224-1324 Ali ASA, Elliot RA, Tata LJ. The direct costs of epilepsy in children and young people: a population based study of health resource utilisation. Epilepsy Research 2014; 108:576-586