TY - JOUR
T1 - Emergency department usage by adults with cerebral palsy
T2 - A retrospective cohort study
AU - Gill, Jaskirath
AU - Morgan, Prue
AU - Enticott, Joanne
N1 - Publisher Copyright:
© 2021 Australasian College for Emergency Medicine
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2022/4
Y1 - 2022/4
N2 - Objective: To retrospectively profile the ED usage for a cohort of adults with cerebral palsy (CP). Methods: Five years of ED data from a Victorian hospital network was analysed to identify participants with CP using the Victorian Emergency Minimum Dataset supplemented with scrutiny of inpatient admission data to identify cases because of limited ED coding of CP. Presentation frequency, emergency diagnoses (International Classification of Diseases, 10th Revision codes) and presentation sequelae were calculated and described. An investigation into rates of low urgency presentations was conducted. Differences between adult and paediatric cohorts were described. Results: Participants with CP constituted 1586 ED presentations. Adults represented 43% (n = 689) of these. Thirty percent of adults presented more than five times over the study period, with respiratory (25%), gastrointestinal (17%) and epilepsy/convulsion diagnoses (11%) being the most common presentations. Rates of inpatient hospital admissions from the ED increased with age in adults (P < 0.001). Low urgency presentations made up 8.9% of total adult presentations. Conclusions: The high rates of respiratory diagnoses and epilepsy/convulsions, both ambulatory care-sensitive conditions, may be indicative of transitional challenges between paediatric and adult healthcare, potentially highlighting difficulties in accessing primary care services. Relatively low rates of ‘low urgency’ presentations may suggest perceived medical fragility in this vulnerable population. People with CP who present to ED and were not admitted may be underrepresented in this data. National expansion of this research will aid the development of an evidence-based model of care for CP in Australia.
AB - Objective: To retrospectively profile the ED usage for a cohort of adults with cerebral palsy (CP). Methods: Five years of ED data from a Victorian hospital network was analysed to identify participants with CP using the Victorian Emergency Minimum Dataset supplemented with scrutiny of inpatient admission data to identify cases because of limited ED coding of CP. Presentation frequency, emergency diagnoses (International Classification of Diseases, 10th Revision codes) and presentation sequelae were calculated and described. An investigation into rates of low urgency presentations was conducted. Differences between adult and paediatric cohorts were described. Results: Participants with CP constituted 1586 ED presentations. Adults represented 43% (n = 689) of these. Thirty percent of adults presented more than five times over the study period, with respiratory (25%), gastrointestinal (17%) and epilepsy/convulsion diagnoses (11%) being the most common presentations. Rates of inpatient hospital admissions from the ED increased with age in adults (P < 0.001). Low urgency presentations made up 8.9% of total adult presentations. Conclusions: The high rates of respiratory diagnoses and epilepsy/convulsions, both ambulatory care-sensitive conditions, may be indicative of transitional challenges between paediatric and adult healthcare, potentially highlighting difficulties in accessing primary care services. Relatively low rates of ‘low urgency’ presentations may suggest perceived medical fragility in this vulnerable population. People with CP who present to ED and were not admitted may be underrepresented in this data. National expansion of this research will aid the development of an evidence-based model of care for CP in Australia.
KW - adult
KW - cerebral palsy
KW - disability
KW - emergency department
KW - health service usage
UR - http://www.scopus.com/inward/record.url?scp=85110539592&partnerID=8YFLogxK
U2 - 10.1111/1742-6723.13832
DO - 10.1111/1742-6723.13832
M3 - Article
C2 - 34278708
AN - SCOPUS:85110539592
SN - 1742-6731
VL - 34
SP - 169
EP - 175
JO - EMA - Emergency Medicine Australasia
JF - EMA - Emergency Medicine Australasia
IS - 2
ER -