Factors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional study

Crilly, Julia; Sweeny, Amy; Muntlin, Åsa; Green, David; Malyon, Lorelle; Christofis, Luke; Higgins, Malcolm; Källberg, Ann-Sofie; Dellner, Sara; Myrelid, Åsa; Djärv, Therese; Göransson, Katarina E.

doi:10.1186/s12913-023-09403-w

Table 4 Predictors of hospital admission for all sites combined for children under 18 years of age

From: Factors predictive of hospital admission for children via emergency departments in Australia and Sweden: an observational cross-sectional study

Predictor	Discharged (n=108,997) (78.6%)		Admitted (n=29,628) (21.4%)		Crude OR & 95% CI	Adjusted OR & 95% CI
Predictor	n	%	n	%	Crude OR & 95% CI	Adjusted OR & 95% CI
Hospital ED
SA children’s	41620	74.7	14077	25.3	1.6 (1.5-1.6)	Not tested
QLD children’s	27354	78.9	7303	21.1	1.2 (1.2-1.3)
QLD mixed	12994	81.4	2962	18.6	1.1 (1.0-1.1)
SA mixed	14160	84.9	2517	15.1	0.8 (0.8-0.9)
Swedish mixed	12869	82.3	2769	17.7	1.0 (Reference)
Hospital ED type
Children’s	68974	76.3	21380	23.7	1.5 (1.5-1.5)	2.3 (2.2-2.4)
Mixed	40023	82.9	8248	17.1	1.0 (Reference)	1.0 (Reference)
Location
South Australia	55780	77.1	16594	22.9	1.4 (1.3-1.4)	Not tested
Queensland	40348	79.7	10265	20.3	1.2 (1.1-1.2)
Sweden	12869	82.3	2769	17.7	1.0 (Reference)
Age category
<12 months	16290	74.8	5487	25.2	1.1 (1.1-1.2)	0.9 (0.9-0.9)
1	14744	79.4	3814	20.6	0.9 (0.8-0.9)	0.8 (0.8-0.9)
2-5	30855	80.1	7679	19.9	0.8 (0.8-0.9)	0.8 (0.8-0.9)
6-11	24514	80.6	5903	19.4	0.8 (0.8-0.8)	0.8 (0.8-0.8)
12-17	22594	77.0	6745	23.0	1.0 (Reference)	1.0 (Reference)
Median age (IQR) years	4 [1,10]		4 [1,10]		4 [1,11]
Sex
Male	59774	78.5	16413	21.5	1.0 (Reference)	Did not enter
Female	49221	78.8	13213	21.2	1.0 (1.0-1.0)
Indigenous status
Aboriginal or Torres Strait Islander	3471	73.9	1224	26.1	1.3 (1.2-1.4)	Not tested
Not Aboriginal or Torres Strait Islander	92023	78.3	25457	21.7	1.0 (Reference)
missing	13503	12.4	2947	9.9
Language spoken at home
English	63128	81.6	14246	18.4	1.0 (Reference)	Not tested
Not English	1124	84.3	210	15.7	0.8 (0.7-1.0)
missing	44745	41.1	15172	51.2
Insurance status
Medicare only	64353	78.4	17767	21.6	1.0 (Reference)	Not tested
Private Health	31257	77.7	8956	22.3	1.0 (1.0-1.1)
No insurance	125	85.6	21	14.4	0.6 (0.4-1.0)
missing	13262	12.2	2884	9.7
Referral source
Self	98554	79.3	25745	20.7	1.0 (Reference)	1.0 (Reference)
Primary health	10120	72.7	3800	27.3	1.4 (1.4-1.5)	1.5 (1.4-1.6)
Community	323	79.6	83	20.4	1.0 (0.8-1.3)	-----
Arrival mode
Private transport	99284	81.5	22604	18.5	1.0 (Reference)	1.0 (Reference)
Ambulance	9407	57.7	6907	42.3	3.2 (3.1-3.3)	2.8 (2.7-2.9)
Other	306	72.3	117	27.7	1.7 (1.3-2.1)	-----
Triage Category ^a
Emergency	7738	45.4	9308	54.6	21.4 (19.6-23.3)	20.8 (18.6-23.3)
Urgent	88699	82.0	19521	18.0	3.9 (3.6-4.2)	4.8 (4.3-5.3)
Less urgent	10745	94.7	605	5.3	1.0 (Reference)	1.0 (Reference)
missing	1815	1.7	194	0.7
Day type of arrival
Weekday	76022	78.0	21460	22.0	1.0 (Reference)	1.0 (Reference)
Weekend	32975	80.1	8168	19.9	0.9 (0.9-0.9)	0.9 (0.9-0.9)
Time of arrival ^b
In-hours	63640	78.3	17686	21.7	1.0 (Reference)	1.0 (Reference)
After-hours	45357	79.2	11942	20.8	0.9 (0.9-1.0)	0.8 (0.8-0.8)
Season of arrival
Spring	32582	78.2	9097	21.8	1.1 (1.0-1.1)	1.1 (1.1-1.2)
Summer	19607	78.8	5270	21.2	1.0 (1.0-1.0)	1.1 (1.1-1.2)
Autumn	22148	78.4	6094	21.6	1.0 (1.0-1.1)	1.1 (1.0-1.1)
Winter	34660	79.1	9167	20.9	1.0 (Reference)	1.0 (Reference)
Top 5 conditions
Trauma vs. all others^c	32154	87.7	4507	12.3	0.4 (0.4-0.5)	0.5 (0.5-0.6)
Infectious vs. all others^c	17152	84.4	3168	15.6	0.7 (0.7-0.7)	0.7 (0.7-0.8)
Ear, nose & throat vs. all others^c	11804	92.3	990	7.7	0.3 (0.3-0.3)	0.3 (0.3-0.4)
Gastrointestinal vs. all others^c	8668	73.0	3201	27.0	1.5 (1.5-1.6)	1.5 (1.4-1.6)
Respiratory vs. all others^c	5864	52.8	5239	47.2	4.1 (4.1-4.3)	2.6 (2.5-2.8)
Missing	2551	49.7	2578	50.3	Not included

ED Emergency department, SA South Australia, QLD Queensland, OR Odds ratio, CI Confidence interval, IQR Inter-quartile range. Note. Presentations ending in a “did not wait”, “deceased” or “unknown” were excluded from regression analysis. The all-sites multivariate model contained data from all sites, but only contained half of the data from Sweden, due to a large number of records without a diagnosis.
^aTriage category: emergency (within 10 minutes: Australasian Triage Scale, ATS 1 or 2, Swedish triage red or orange), urgent (within 60 minutes: ATS 3 or 4, Swedish triage yellow), less urgent (>60 minutes: ATS 5, Swedish triage green or blue);
^bTime of arrival: In-hours: 06:00-17:59; After-hours: 18:00-05:59;
^creference category is all other diagnoses; Did not enter: tested, but not statistically significant after adjusting for other variables in model; Not tested: due to missing data at one or more sites.

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