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Migration may be driving sharp rise in children being admitted to intensive care

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The number of children admitted to intensive care in England and Wales has risen sharply since 2009, adding further strain to an already overstretched NHS, warn researchers.

The number of children admitted to paediatric intensive care (PIC) has gone up over the past 20 years due to the rising birth rate and the increasing number of babies surviving extreme prematurity.

“Increasing numbers of critically ill children requiring PIC will prove challenging”

Study authors

But the new study found a surge in admissions since 2009 that the authors said was not explained by either population growth or rising birth rates.

The trend may be the result of higher migration levels in certain regions, suggest the researchers from Bristol and Leicester.

They analysed data on population levels and paediatric intensive care admissions for children up to the age of 15 between 2004 and 2013.

The analysis showed that the numbers of children admitted to intensive care rose for all age groups throughout the study period – by nearly 15% in England and by just over 2% in Wales.

Admission rates were higher among boys than girls, said the researchers, and also among children of South Asian ethnicity – traditionally at an increased risk of admission to intensive care.

The steepest rises were seen among younger children up to the age of five years, and those with breathing or cardiovascular problems. Infants under one made up almost half the annual total.

However, from 2009 onwards, more children were admitted than would be expected based on birth rate, ethnic background and requiring of help with breathing – an indicator of critical illness.

In fact, the numbers of children requiring assisted ventilation rose significantly over the study period and, therefore, could not be attributed to a lowering in the admission threshold for intensive care.

In addition, while the numbers of children being admitted to intensive care has risen since the centralisation of facilities in 2002, it still does not explain the surge after 2009, said the researchers.

However, they suggested migration may be a factor. Admission rates were particularly high in five regions of England, with the South Central region top of the league table.

Here, admissions rose by more than 43%, followed by London at nearly 31%, the East of England at nearly 23%, the West Midlands at 22.5%, and the South East Coast at nearly 12%.

These five regions also had the highest numbers of mothers born outside the UK, particularly Eastern Europe, noted the researchers in the journal the Archives of Disease in Childhood.

But whatever the reasons, they warned the rise in the number of children with chronic complex conditions looks set to continue, putting further strain on an already overstretched health service.

“Increasing numbers of critically ill children requiring PIC in England and Wales, will prove challenging both for [these] services and commissioners, as increased demand potentially outstrips resource,” they stated.

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