A high uptake of preventive primary care, including vaccination and development checks, is associated with fewer unplanned and ambulatory care sensitive (ACS) hospital admissions from birth and through childhood, suggests a new study published in the journal BMC Medicine.
The largest ever analysis examining how infant vaccinations and development checks in primary care are linked to children’s risk of emergency hospital admissions tracked 319,730 children in England born between January 2000 and March 2013.
The researchers used Cox regression estimating adjusted hazard ratios (HR) to examine subsequent risk of unplanned and ACS hospital admissions in children who received preventive primary care compared with those who did not.
Overall, 98 per cent of children had complete vaccinations and 87 per cent had development checks.
Infants with incomplete vaccination had increased risk for all unplanned hospital admissions (HR 1.89; 95% CI 1.79-2.00), and vaccine-preventable admissions (HR 4.41; 95% CI 2.59-7.49). Infants lacking development checks also had higher risk for unplanned hospital admission (HR 4.63; 95% CI 4.55-4.71). These associations persisted across childhood.
One third of all unplanned hospital admissions (62,154/183,530) were for ACS infectious illnesses. Children who had a chronic condition like asthma or epilepsy were at particularly high risk of an emergency hospital admission if they missed out on vaccinations or development checks.
Strengthening immunisation coverage and preventive primary care in countries with poor universal healthcare coverage could potentially significantly reduce the health burden from hospital admission in children, the study concluded.