Do hospital pressures change following rotavirus vaccine introduction? a retrospective database analysis in a large paediatric hospital in the UK

Ellen Heinsbroek, Daniel Hungerford, Richard P.D. Cooke, Margaret Chowdhury, James S. Cargill, Naor Bar-Zeev, Neil French, Eleni Theodorou, Baudouin Standaert, Nigel A. Cunliffe

Research output: Contribution to journalArticle

Abstract

Objective Hospitals in the UK are under increasing clinical and financial pressures. Following introduction of childhood rotavirus vaccination in the UK in 2013, rotavirus gastroenteritis (RVGE) hospitalisations reduced significantly. We evaluated changes in â € hospital pressures' (demand on healthcare resources and staff) following rotavirus vaccine introduction in a paediatric setting in the UK. Design Retrospective hospital database analysis between July 2007 and June 2015. Setting A large paediatric hospital providing primary, secondary and tertiary care in Merseyside, UK. Participants Hospital admissions aged <15 years. Outcomes were calculated for four different patient groups identified through diagnosis coding (International Classification of Disease, 10th edition) and/or laboratory confirmation: all admissions; any infection, acute gastroenteritis and RVGE. Methods Hospital pressures were compared before and after rotavirus vaccine introduction: these included bed occupancy, hospital-acquired infection rate, unplanned readmission rate and outlier rate (medical patients admitted to surgical wards due to lack of medical beds). Interrupted time-series analysis was used to evaluate changes in bed occupancy. Results There were 116 871 admissions during the study period. Lower bed occupancy in the rotavirus season in the postvaccination period was observed for RVGE (-89%, 95% CI 73% to 95%), acute gastroenteritis (-63%, 95% CI 39% to 78%) and any infection (-23%, 95% CI 15% to 31%). No significant overall reduction in bed occupancy was observed (-4%, 95% CI -1% to 9%). No changes were observed for the other outcomes. Conclusions Rotavirus vaccine introduction was not associated with reduced hospital pressures. A reduction in RVGE hospitalisation without change in overall bed occupancy suggests that beds available were used for a different patient population, possibly reflecting a previously unmet need.

Original languageEnglish (US)
Article number027739
JournalBMJ open
Volume9
Issue number5
DOIs
StatePublished - May 1 2019

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Rotavirus Vaccines
Bed Occupancy
Pediatric Hospitals
Rotavirus
Gastroenteritis
Databases
Pressure
Hospitalization
Hospital Design and Construction
Secondary Care
International Classification of Diseases
Tertiary Healthcare
Cross Infection
Infection
Primary Health Care
Vaccination
Pediatrics
Delivery of Health Care
Population

Keywords

  • Epidemiology
  • Hospital
  • Nosocomial infections
  • Quality in health care
  • Rotavirus

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Do hospital pressures change following rotavirus vaccine introduction? a retrospective database analysis in a large paediatric hospital in the UK. / Heinsbroek, Ellen; Hungerford, Daniel; Cooke, Richard P.D.; Chowdhury, Margaret; Cargill, James S.; Bar-Zeev, Naor; French, Neil; Theodorou, Eleni; Standaert, Baudouin; Cunliffe, Nigel A.

In: BMJ open, Vol. 9, No. 5, 027739, 01.05.2019.

Research output: Contribution to journalArticle

Heinsbroek, E, Hungerford, D, Cooke, RPD, Chowdhury, M, Cargill, JS, Bar-Zeev, N, French, N, Theodorou, E, Standaert, B & Cunliffe, NA 2019, 'Do hospital pressures change following rotavirus vaccine introduction? a retrospective database analysis in a large paediatric hospital in the UK', BMJ open, vol. 9, no. 5, 027739. https://doi.org/10.1136/bmjopen-2018-027739
Heinsbroek, Ellen ; Hungerford, Daniel ; Cooke, Richard P.D. ; Chowdhury, Margaret ; Cargill, James S. ; Bar-Zeev, Naor ; French, Neil ; Theodorou, Eleni ; Standaert, Baudouin ; Cunliffe, Nigel A. / Do hospital pressures change following rotavirus vaccine introduction? a retrospective database analysis in a large paediatric hospital in the UK. In: BMJ open. 2019 ; Vol. 9, No. 5.
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title = "Do hospital pressures change following rotavirus vaccine introduction? a retrospective database analysis in a large paediatric hospital in the UK",
abstract = "Objective Hospitals in the UK are under increasing clinical and financial pressures. Following introduction of childhood rotavirus vaccination in the UK in 2013, rotavirus gastroenteritis (RVGE) hospitalisations reduced significantly. We evaluated changes in {\^a} € hospital pressures' (demand on healthcare resources and staff) following rotavirus vaccine introduction in a paediatric setting in the UK. Design Retrospective hospital database analysis between July 2007 and June 2015. Setting A large paediatric hospital providing primary, secondary and tertiary care in Merseyside, UK. Participants Hospital admissions aged <15 years. Outcomes were calculated for four different patient groups identified through diagnosis coding (International Classification of Disease, 10th edition) and/or laboratory confirmation: all admissions; any infection, acute gastroenteritis and RVGE. Methods Hospital pressures were compared before and after rotavirus vaccine introduction: these included bed occupancy, hospital-acquired infection rate, unplanned readmission rate and outlier rate (medical patients admitted to surgical wards due to lack of medical beds). Interrupted time-series analysis was used to evaluate changes in bed occupancy. Results There were 116 871 admissions during the study period. Lower bed occupancy in the rotavirus season in the postvaccination period was observed for RVGE (-89{\%}, 95{\%} CI 73{\%} to 95{\%}), acute gastroenteritis (-63{\%}, 95{\%} CI 39{\%} to 78{\%}) and any infection (-23{\%}, 95{\%} CI 15{\%} to 31{\%}). No significant overall reduction in bed occupancy was observed (-4{\%}, 95{\%} CI -1{\%} to 9{\%}). No changes were observed for the other outcomes. Conclusions Rotavirus vaccine introduction was not associated with reduced hospital pressures. A reduction in RVGE hospitalisation without change in overall bed occupancy suggests that beds available were used for a different patient population, possibly reflecting a previously unmet need.",
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AU - Heinsbroek, Ellen

AU - Hungerford, Daniel

AU - Cooke, Richard P.D.

AU - Chowdhury, Margaret

AU - Cargill, James S.

AU - Bar-Zeev, Naor

AU - French, Neil

AU - Theodorou, Eleni

AU - Standaert, Baudouin

AU - Cunliffe, Nigel A.

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N2 - Objective Hospitals in the UK are under increasing clinical and financial pressures. Following introduction of childhood rotavirus vaccination in the UK in 2013, rotavirus gastroenteritis (RVGE) hospitalisations reduced significantly. We evaluated changes in â € hospital pressures' (demand on healthcare resources and staff) following rotavirus vaccine introduction in a paediatric setting in the UK. Design Retrospective hospital database analysis between July 2007 and June 2015. Setting A large paediatric hospital providing primary, secondary and tertiary care in Merseyside, UK. Participants Hospital admissions aged <15 years. Outcomes were calculated for four different patient groups identified through diagnosis coding (International Classification of Disease, 10th edition) and/or laboratory confirmation: all admissions; any infection, acute gastroenteritis and RVGE. Methods Hospital pressures were compared before and after rotavirus vaccine introduction: these included bed occupancy, hospital-acquired infection rate, unplanned readmission rate and outlier rate (medical patients admitted to surgical wards due to lack of medical beds). Interrupted time-series analysis was used to evaluate changes in bed occupancy. Results There were 116 871 admissions during the study period. Lower bed occupancy in the rotavirus season in the postvaccination period was observed for RVGE (-89%, 95% CI 73% to 95%), acute gastroenteritis (-63%, 95% CI 39% to 78%) and any infection (-23%, 95% CI 15% to 31%). No significant overall reduction in bed occupancy was observed (-4%, 95% CI -1% to 9%). No changes were observed for the other outcomes. Conclusions Rotavirus vaccine introduction was not associated with reduced hospital pressures. A reduction in RVGE hospitalisation without change in overall bed occupancy suggests that beds available were used for a different patient population, possibly reflecting a previously unmet need.

AB - Objective Hospitals in the UK are under increasing clinical and financial pressures. Following introduction of childhood rotavirus vaccination in the UK in 2013, rotavirus gastroenteritis (RVGE) hospitalisations reduced significantly. We evaluated changes in â € hospital pressures' (demand on healthcare resources and staff) following rotavirus vaccine introduction in a paediatric setting in the UK. Design Retrospective hospital database analysis between July 2007 and June 2015. Setting A large paediatric hospital providing primary, secondary and tertiary care in Merseyside, UK. Participants Hospital admissions aged <15 years. Outcomes were calculated for four different patient groups identified through diagnosis coding (International Classification of Disease, 10th edition) and/or laboratory confirmation: all admissions; any infection, acute gastroenteritis and RVGE. Methods Hospital pressures were compared before and after rotavirus vaccine introduction: these included bed occupancy, hospital-acquired infection rate, unplanned readmission rate and outlier rate (medical patients admitted to surgical wards due to lack of medical beds). Interrupted time-series analysis was used to evaluate changes in bed occupancy. Results There were 116 871 admissions during the study period. Lower bed occupancy in the rotavirus season in the postvaccination period was observed for RVGE (-89%, 95% CI 73% to 95%), acute gastroenteritis (-63%, 95% CI 39% to 78%) and any infection (-23%, 95% CI 15% to 31%). No significant overall reduction in bed occupancy was observed (-4%, 95% CI -1% to 9%). No changes were observed for the other outcomes. Conclusions Rotavirus vaccine introduction was not associated with reduced hospital pressures. A reduction in RVGE hospitalisation without change in overall bed occupancy suggests that beds available were used for a different patient population, possibly reflecting a previously unmet need.

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KW - Hospital

KW - Nosocomial infections

KW - Quality in health care

KW - Rotavirus

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