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Hospital admission patterns subsequent to diagnosis of type 1 diabetes in children : a systematic review

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Angus, Val C. and Waugh, Norman. (2007) Hospital admission patterns subsequent to diagnosis of type 1 diabetes in children : a systematic review. BMC Health Services Research, Vol.7 (No.1). p. 199. ISSN 1472-6963

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Abstract

Background
Patients with type 1 diabetes are known to have a higher hospital admission rate than the underlying population and may also be admitted for procedures that would normally be carried out on a day surgery basis for non-diabetics. Emergency admission rates have sometimes been used as indicators of quality of diabetes care.

In preparation for a study of hospital admissions, a systematic review was carried out on hospital admissions for children diagnosed with type 1 diabetes, whilst under the age of 15. The main thrust of this review was to ascertain where there were gaps in the literature for studies investigating post-diagnosis hospitalisations, rather than to try to draw conclusions from the disparate data sets.

Methods
A systematic search of the electronic databases PubMed, Cochrane LibrarMEDLINE and EMBASE was conducted for the period 1986 to 2006, to identify publications relating to hospital admissions subsequent to the diagnosis of type 1 diabetes under the age of 15.

Results
Thirty-two publications met all inclusion criteria, 16 in Northern America, 11 in Europe and 5 in Australasia. Most of the studies selected were focussed on diabetic ketoacidosis (DKA) or diabetes-related hospital admissions and only four studies included data on all admissions. Admission rates with DKA as primary diagnosis varied widely between 0.01 to 0.18 per patient-year as did those for other diabetes-related co-morbidity ranging from 0.05 to 0.38 per patient year, making it difficult to interpret data from different study designs. However, people with Type 1 diabetes are three times more likely to be hospitalised than the non-diabetic populations and stay in hospital twice as long.

Conclusion
Few studies report on all admissions to hospital in patients diagnosed with type 1 diabetes whilst under the age of 15 years. Health care costs for type 1 patients are higher than those for the general population and information on associated patterns of hospitalisation might help to target interventions to reduce the cost of hospital admissions.

Item Type: Journal Article
Subjects: R Medicine > RJ Pediatrics
Divisions: Faculty of Medicine > Warwick Medical School > Warwick Evidence
Faculty of Medicine > Warwick Medical School > Health Sciences
Library of Congress Subject Headings (LCSH): Diabetes in children -- Complications, Diabetics -- Hospital care
Journal or Publication Title: BMC Health Services Research
Publisher: Bio Med Central
ISSN: 1472-6963
Official Date: 2007
Volume: Vol.7
Number: No.1
Page Range: p. 199
Identification Number: 10.1186/1472-6963-7-199
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
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URI: http://wrap.warwick.ac.uk/id/eprint/49876

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