Variation in health care for children and young people with cerebral palsies: a retrospective multicentre audit study.

Autor: Horridge K; City Hospitals Sunderland NHS Foundation Trust, Sunderland Royal Hospital, Sunderland, UK., Tennant PW; Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK., Balu R; County Durham and Darlington NHS Foundation Trust, Durham, UK., Rankin J; Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.; PHE: Regional Maternity Survey Office, Newcastle upon Tyne, UK.
Jazyk: angličtina
Zdroj: Developmental medicine and child neurology [Dev Med Child Neurol] 2015 Sep; Vol. 57 (9), pp. 844-51. Date of Electronic Publication: 2015 Mar 24.
DOI: 10.1111/dmcn.12740
Abstrakt: Aim: To explore the provision and variations in care for children and young people with cerebral palsies (CP) registered with the population-based North of England Collaborative Cerebral Palsy Survey (NECCPS).
Method: This is a retrospective multicentre record audit of 389 children with CP (220 males, 148 females, 21 no data; median age at time of audit 12y 3mo), born between 1995 and 2002. Data were collected on cranial magnetic resonance imaging (MRI), hip and spine surveillance and management, and pain presence and management. Variations over time and between the districts in the north of England (Northumberland, North and West Cumbria, North and South Tyneside, Newcastle-upon-Tyne, Gateshead, Sunderland, Durham, Darlington, Bishop Auckland, Hartlepool, Stockton-on-Tees, Middlesbrough, Redcar, and Cleveland), and by socio-economic status (SES) (estimated from the Index of Multiple Deprivation [IMD] 2004) were estimated by generalized estimating equations.
Results: There was significant variation between districts in access to MRI (p<0.001), orthopaedic surgeons (p=0.005), recording state of spine (p<0.001), and discussions about pain (p<0.001). Fifty-seven per cent (95% CI 52-62) had evidence of a reported MRI brain scan, the proportion of which increased over time (p<0.001). Sixty-seven per cent (95% CI 62-71) had a discussion about pain recorded. Of those in pain, 87% (95% CI 80-93) had a pain management plan. The proportion with documented discussion about pain increased with increasing SES (p=0.04).
Interpretation: The provision of care for children with CP in the north of England varies between districts. Internationally agreed, evidence-based standards are urgently needed to ensure more equitable health care and improved outcomes for all.
(© 2015 Mac Keith Press.)
Databáze: MEDLINE
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