A&E Attendances and Hospital Admissions Among Children and Young People

This topic area covers statistics and information relating to A&E attendances and hospital admissions among children and young people including local strategic need and service provision. Further information relating to hospital admissions as a result of unintentional and deliberate injuries can be found within Accidents and Injuries Among Children and Young People under Health Factors under Children and Young People. Information on hospital admissions for specific diseases and medical conditions among adults can be found on the specific pages for that disease or medical condition within Health Factors under Adults.

This page contains information from the Office for Health Improvement & Disparities’ Fingertips. Information is taken ‘live’ from the site so uses the latest available data from Fingertips and displays it on this page. As a result, some comments on this page may relate to an earlier period of time until this page is next updated (see review dates at the end of this page).

The Office for National Statistics ‘back-date’ their recent estimates of the resident population once more accurate Census data becomes available. Their revised estimates were released for each local authority on the 23 November 2023. Prior to this, the Office for Health Improvement & Disparities removed their trend data which relied on resident population estimates from Fingertips (affecting trends in hospital admission rates). The majority of indicators have been updated but some of the ones affecting hospital admission rates among children have not yet been updated. Some of the statements on our website pages have been retained with the comments relating to the trend data when it was shown on Fingertips even though the trend data is not shown, and the actual values will change (in most cases slightly) once the calculations are redone using the new backdated population estimates.

Headlines

• The rate of A&E attendances in Hull among infants aged under one year and children aged 0-4 years was comparable to England in 2016/17, but has increased sharply and both rates are around 40% higher than England for 2022/23. The A&E admission rates are the second highest in the region among under ones and highest among under fives (and highest by some margin for under fives). On average, infants are attending A&E 1.5 occasions per year, and all children aged 0-4 years are attending 1.1 occasions per year.
• The rate of emergency hospital admissions for babies under 14 days, and children aged 0-4 years are both lower than England for 2022/23. Admissions for gastroenteritis among those aged under one year, aged one year and aged 2-4 years in Hull are all comparable to England for 2022/23 with rates having decreased over the last decade among infants aged under 0ne and infants aged one year. Hospital admission rates for lower respiratory tract infections are also comparable (or lower) in Hull compared to England for 2022/23, although rates have been increasing over time particularly among infants aged under one year and infants aged one year.
• Given that A&E attendance has increased so markedly among those under five years of age, it is perhaps not surprising that this has occurred among under 18s too. The rate of A&E attendance was slightly lower in Hull than England in 2011/12, but increased gradually from 346 to 478 attendances per 1,000 population in 2016/17. The rate increased to 694 attendances per 1,000 population in 2019/20 (67% higher than England) and whilst it did decrease in 2020/21 due to the COVID-19 pandemic, the rate has returned to pre-pandemic levels with 684 attendances per 1,000 population in 2022/23. There were 41,810 A&E attendances among under 18s in Hull during 2022/23 equating to an average of 0.68 attendances for each child living in Hull. In contrast, the emergency hospital admission rate among under 18s in Hull was comparable to England with 71 admissions per 1,000 population. The admission rate had been statistically significantly higher than England prior to the pandemic, but decreased sharply in 2020/21 to a level which was statistically significantly lower than England. Whilst the admission rate has increased in Hull over the last two years, the rate is lower than pre-pandemic admission rates. In 2022/23, there were 4,285 admissions among under 18s and the admission rate in Hull.
• During 2022/23, the rate of emergency hospital admissions among under 19s for asthma in Hull were considerably lower than England and for the case of children aged 0-9 years statistically significantly lower. The asthma admissions rates fell sharply during 2020/21 due to the pandemic among 10-18 year olds and whilst they have increased since are still below pre-pandemic levels. Among those aged 0-9 years, asthma admissions rates have drastically decreased over the last decade or so. The rate among 0-9 year olds only fell slightly during the pandemic, and whilst rates have increased slightly since, they are currently comparable to pre-pandemic rates. There were 45 hospital admissions for asthma among under 19s in Hull during 2022/23 (25 aged 0-9 years and 20 aged 10-18 years).
• During 2022/23, the rate of emergency hospital admissions among under 19s for diabetes in Hull were comparable to England albeit slightly higher among those aged 10-18 years and overall among all those aged under 18 years. Admission rates have been relative static among those aged 0-9 and 10-18 years although there has been year-on-year variability. There were a particularly high number of hospital admissions during 2021/22 for both 0-9s and 10-18s, although it could be due to multiple admissions for the same children. There were 40 hospital admissions for diabetes among under 19s in Hull during 2022/23 (10 aged 0-9 years and 30 aged 10-18 years).
• During 2022/23, the emergency hospital admissions among under 19s for epilepsy was statistically significantly higher in Hull compared to England for young people aged 10-18 years and all those aged under 18 years. The rate was also higher in Hull among those aged 0-9 years but the difference was not statistically significantly different from England. The epilepsy admission rate among young people aged 10-18 years has remained relatively static in Hull although there has been some year-on-year variability, whereas the rate among those aged 0-9 years has drastically reduced over time. There were 70 hospital admissions for epilepsy among under 19s in Hull during 2022/23 (35 aged 0-9 years and 35 aged 10-18 years).
• During 2022/23, hospital admission rate for self-harm in Hull among young people aged 10-24 years was marginally higher than England (332 versus 319 per 100,000 population). However, there is a difference by age with rates statistically significantly higher among Hull residents aged 20-24 years. For all ages 10-24 years combined, the rate has been gradually decreasing in Hull. However, the rate has increased for those aged 10-14 years over the last three years, substantially decreased among those aged 15-19 years with a slight increase in the last two years, and decreased among those aged 20-24 years with a slight increase in the last year. There were 170 hospital admissions for self-harm among young people aged 10-24 years in Hull during 2022/23 (35 aged 10-14 years, 60 aged 15-19 years and 75 aged 20-24 years).
• Hospital admissions for mental health in Hull were twice as high in Hull compared to England during 2022/23 for under 18s. Over the entire 11-year period 2010/11 to 2020/21, the hospital admission rate was lower in Hull compared to England and in some cases statistically significantly lower in Hull than England. However, the rate almost tripled from 68 to 186 admissions per 100,000 population between 2020/21 and 2021/22, and whilst the rate has decreased slightly in 2022/23 to 166 admissions per 100,000 population, the admission rate in Hull is still very high. There were 100 hospital admissions for mental health in Hull among under 18s during 2022/23, but in 2020/21 there has been around 40 admissions.
• The admission rate for alcohol-specific conditions among under 18s has been considerably and statistically significantly higher in Hull compared to England, particularly for men, but the rate has reduced sharply in Hull and the rate is now comparable or lower than England for the latest three year period 2020/21 to 2022/23. In contrast to adults, there are higher admission rates for females compared to males among under 18s (and this is the case not just in Hull but across England and the region). Over the three year period 2020/21-2022/23, there were 15 male and 15 female admissions for alcohol-specific conditions in Hull equating to around 35 admissions each year (numbers rounded to nearest five).

The Population Affected – Why Is It Important?

Hospitals and the NHS are currently under extreme stress and pressure in terms of increased numbers of people attending A&E and being admitted to hospital. This has always been the case during winter months, but increasingly this pressure is arising throughout the entire year, and this has increased dramatically with the COVID pandemic.

Thus, whilst it is important that people seek medical help early in an emergency or where there is serious medical need, it is also important that people do not attend A&E when a more appropriate service should have been accessed instead. Such attendances will potentially mean that treatment is delayed for those most in need of urgent medical help.

Furthermore, attendances at A&E and admissions to hospital, particularly emergency hospital admissions which are the most expensive for the NHS can be minimised through prevention such as reducing exposure to second-hand smoke, accident prevention, improved road safety, and access to other early help community services such as pharmacies and urgent treatment centres.

The rates of A&E attendance and hospital admissions are given on The Office for Health Improvement & Disparities’ Fingertips, and the information is presented for different age groups, and for different types of causes of admission and different medical conditions. Hospital admission rates are given for asthma, diabetes, epilepsy, unintentional and deliberate injuries, self-harm and mental health, and admissions due to alcohol and substance use. For children aged under five years, admission rates are also given for gastroenteritis and lower respiratory tract infections.

Note that most of the rates presented below are described as rates of hospital admissions with the exception of those relating to alcohol which are stated as rates of hospital episodes. Each hospital admission, hospital stay or hospital ‘spell’ is made up of one or more hospital episodes. Each hospital episode relates to a period of care for a patient under a single consultant within one hospital provider. Thus if a patient moves from one consultant to another (for example, if they move from one speciality to another), or if a patient is transferred to another hospital (for example, if they require specialist care) then there will be more than one hospital episode for that hospital stay. In most cases, a hospital stay has a single hospital episode, but for a small number of hospital stays there can be a relatively large number of hospital episodes. However, in relation to hospital admission data presented on The Office for Health Improvement & Disparities’ Fingertips for children and young people, only those relating to alcohol mention hospital episodes and despite this, the information presented appears to be hospital admissions rather than hospital episodes based on information presented in their definitions section. However, the figures do not generally relate to patients, and some children may have more than one hospital admission within a single specified period of time.

The number of hospital admissions are generally rounded to the nearest five. In most cases, the rates of A&E attendance and hospital admission are given as a crude rate, but the hospital admission rates for alcohol-specific conditions and substance use are given as directly standardised rates (adjusted to take into consideration the age distribution of the local population).

Note also that the rate of A&E attendances and hospital admission are influenced by local variation in referral and admission practices as well as variation in incidence or prevalence.

The Hull Picture

A&E Attendances Among Under Fives

For 2022/23, A&E attendances among those aged under one year and 0-4 years in Hull are considerably higher in Hull compared to England. Both rates are statistically significantly higher than England being 37% higher for under ones and 42% higher for under fives.

The number of A&E attendances are given as a rate per 1,000 population.

The A&E attendance rate for under ones is the second highest in the region for 2022/23.

For 2022/23, the A&E attendance rate for under fives is the highest in the region (by some margin).

The A&E attendance rate in Hull was comparable to England in 2016/17, but has since increased markedly for both infants under one year and those aged 0-4 years. Significant numbers of infants under the age of one year are attending A&E more than once in the year as there are just under 3,100 births in Hull each year. From the Office for National Statistics, resident population estimates for Hull for mid-year 2022, the population aged under one year is estimated to be 3,228 and the population aged 0-4 years is estimated to be 15,945.

Thus it is estimated, on average, each infant in Hull visited A&E on 1.5 occasions during 2022/23, and that each child aged 0-4 years in Hull visited A&E on 1.1 occasions during 2022/23. Some children will have not attended A&E at all, whereas other children will have attended multiple times over the year.

Hospital Admissions Among Under Fives

Emergency Hospital Admissions Among Babies Under 14 Days

The rate of emergency hospital admissions for babies aged under 14 days (per 1,000 population) were considerably lower and statistically significantly lower in Hull compared to England for 2022/23.

The emergency hospital admission rate for babies under 14 days has also been significantly lower than England each year since 2014/15.

Emergency Hospital Admissions Among All Under Fives

The rate of emergency hospital admissions among children under five years of age in Hull is comparable to England 2022/23.

The rates are given as the number of admissions per 1,000 population.

However, until 2019/20, emergency hospital admissions among children aged 0-4 years had consistently been significantly higher in Hull compared to England with over 3,000 admissions in Hull per year. Until 2020/21, the rate had not changed much over time, although there had been some year-on-year changes.

For 2020/21, there was a huge reduction in the emergency hospital admission rate among under fives in Hull with the rate more than halving from 181 to 82 admissions per 1,000 population. There was a similar reduction for both England and the region, but the size of the reductions were lower. As a consequence, the rate in Hull was for the first time lower than England and the region, and in fact statistically significantly lower than England.

Between 2020/21 and 2021/22, the rates increased drastically, but the rate in England returned to pre-pandemic levels and the rate for the region increased to above pre-pandemic levels. In contrast, the increase in the rate for Hull was not as high, and the admission rates for 2021/22 were over 10% lower than those in 2019/20 prior to the pandemic. The rate remained relatively unchanged in Hull between 2021/22 and 2022/23. As a consequence of the different pattern in the changes during and after the pandemic, the rate in Hull has been comparable to England for the last two years.

Hospital Admissions for Gastroenteritis

For 2022/23, the rate of hospital admissions for gastroenteritis in infants under one year of age and one year of age in Hull are both slightly lower than England, and the rate among children aged 2-4 years is marginally higher than England. There is no statistically significant difference in the rates between Hull and England for any of the three age groups.

The rates are given as the number of admissions per 10,000 population.

Among infants under one year of age and children aged one year, the rates in Hull have generally been higher than England around five to ten years ago. However, in the last five years or so, the rates have steadily decreased in Hull and are now comparable to England.

The number of hospital admissions for gastroenteritis are relatively low and there is year-on-year variability in the number of admissions in Hull (see Small Numbers for more information). Furthermore, it is possible that there could be multiple hospital admissions from the same children in a single financial year.

There was a considerable decrease in the number of admissions between 2019/20 and 2020/21 due to the pandemic, but the rates increased the next year. Ignoring the year 2019/20, the rates in 2021/22 and 2022/23 were on the same trajectory as the overall decreases in the last decade.

Between 2011/12 and 2022/23, the rate decreased by 76% for under ones and by 72% for one year olds. This means that the rate in 2022/23 is less than a quarter the rate it was in 2011/12 for those aged under one year, and a less than a third the rate it was in 2011/12 for those aged one year.

For 2011/12, there were 165 infants under one year and 105 children aged one year who were admitted to hospital as an emergency in Hull for gastroenteritis, but this decreased to 35 under ones and to 25 children aged one year for 2022/23.

Among children aged 2-4 years, the trends in the admissions rates for gastroenteritis in Hull differ compared to younger children. There was a reduction followed by an increase due to the COVID-19 pandemic which was similar, and there is also year-on-year variability. However, over the entire period 2011/12 to 2022/23, there has only been relatively minor decreases from 68.8 admissions in 2011/12 to 51.8 admissions in 2022/23 per 10,000 population. This represents a decrease of 25%. This is a substantial reduction, but not as great as that among the younger ages.

For 2011/12, there were 70 children aged 2-4 years who were admitted for gastroenteritis in Hull, but this reduced to 50 children for 2022/23.

Hospital Admissions for Lower Respiratory Tract Infections

In 2022/23, hospital admissions for lower respiratory tract infections in infants under one year and those aged one year were both comparable to England in that neither were statistically significantly different between Hull and England. Among children aged 2-4 years, the rate of admission was statistically significantly lower in Hull.

The rates are given as the number of admissions per 10,000 population.

Among infants aged under one year, the admission rate for lower respiratory tract infections has been gradually increasing in Hull, and has been statistically significantly higher than England for most years. Whilst the rate was affected by the pandemic with a very large decrease between 2019/20 and 2020/21 with rates decreasing six-fold, the rates increased the next year back to a similar trajectory observed prior to the pandemic albeit marginally lower.

The change in the admission rates for lower respiratory tract infections among babies aged under one year in Hull mirrored the pattern observed for England and the region, with the only real difference being the fact that the admission rate in Hull was generally higher.

It is possible that the higher admission rate over time is associated with better data recording of lower respiratory tract infections.

During 2022/23, there were 280 hospital admissions among infants aged under one year in Hull, although it is possible that some infants could have been admitted more than once during that year.

Compared to infants aged under one year, the admission rate for lower respiratory tract infections among children aged one year followed a reasonably similar pattern to 2020/21. The only real differences were that the admission rates in Hull were generally lower or comparable to England.

Since the pandemic, the pattern differed in relation to those aged under ones, although the changes nationally and regionally were mirrored in Hull for children aged one year.

The rate of increase following the pandemic has been relatively large for those aged one year in Hull with the latest admission rate at 179 admissions per 10,000 population considerably higher than the pre-pandemic rate in 2019/20 of 93 admissions per 10,000 population.

Again, it is possible that the higher admission rate over time is associated with better data recording of lower respiratory tract infections.

During 2022/23, there were 55 hospital admissions among infants aged one year in Hull, although it is possible that some infants could have been admitted more than once during that year.

The numbers of hospital admissions were relatively low potentially resulting in year-on-year variability (see Small Numbers for more information).

The pattern in the trends over time for those aged 2-4 years was also similar to the younger ages with the pattern for 2-4 year olds more similar to children aged one year.

The numbers of hospital admissions were very low for some years and this results in year-on-year variability (see Small Numbers for more information). Furthermore, it would appear that there was also a reduction in Hull for 2020/21, but the information is not presented for this year. It is likely that the numbers are too small to be presented. As a consequence, the trend looks slightly different on the chart.

Similar to infants aged one year, the admission rate among children aged 2-4 years has been consistently comparable or lower than England, although for most years statistically significantly lower than England. The rate of increase following the pandemic has also been relatively large for those aged 2-4 years in Hull with the latest admission rate at 25.9 admissions per 10,000 population considerably higher than the pre-pandemic rate in 2019/20 of 14.6 admissions per 10,000 population.

Hospital Admissions for Accidents and Injuries

The emergency hospital admission rate for admissions caused by unintentional and deliberate injuries among those aged 0-4 years is statistically significantly lower in Hull compared to England in 2022/23. Rates are given as emergency hospital admissions per 10,000 population.

The rate of admissions in Hull has decreased among those aged 0-4 years. The rate reduced by one-third from 2011/12 when the rate was at its highest at 167.7 admissions per 10,000 population to 2019/20 (to 124.4 per 10,000 population). There was a relatively sharp decrease between 2019/20 and 2020/21 (decreasing by 22%), which is likely to have occurred – at least in part – due to the COVID-19 pandemic. People’s behaviours changed throughout the pandemic which could have influenced the number of accidents and injuries that occurred. Furthermore, people may have been less likely to attend A&E for instance which may have reduced the likelihood of hospital admission. Over the same period of time, the decreases in England and across the region have not been as marked. However, between 2020/21 and 2022/23, there have been further relatively large decreases in the admission rate in Hull such that the rate is statistically significantly lower in Hull compared to England for the first time.

The rate has also decreased over time England and the region, but the reductions in Hull have been slightly greater over the entire time period 2010/11 to 2022/23.

Among children aged 0-4 years living in Hull, there were 120 hospital admissions caused by unintentional and deliberate injuries in 2022/23 which was almost one-third of the number for 2011/12 when there were 326 admissions (numbers generally are rounded to the nearest five on Fingertips).

Further information is available on the type of injury from The Office for Health Improvement & Disparities’ Fingertips for those aged 0-4 years, and is presented within Accidents and Injuries Among Children and Young People under Health Factors under Children and Young People.

Hospital Admissions Among Children Aged 0-9 Years

Hospital Admissions for Asthma, Epilepsy and Diabetes

For 2022/23, emergency hospital admissions among children aged 0-9 years were half the rate in Hull compared to England for asthma, similar to England for diabetes and 14% higher for epilepsy.

The rate is given as the number of hospital admissions per 100,000 population aged 0-9 years.

The numbers of hospital admissions were relatively low though potentially resulting in year-on-year variability (see Small Numbers for more information). Furthermore, it is possible that there could be multiple hospital admissions from the same children within the same financial year.

Between 2010/11 and 2022/23, the rate of hospital admissions for asthma has shown a marked decrease in Hull. Furthermore, the rate has decreased at a faster rate than England over the same time period which has reduced the inequalities gap to the extent that the rate in Hull is now lower than that of England. The hospital admission rate in Hull for 2010/11 was 50% higher than England, but in 2021/22 the rate in Hull is half that of England’s rate.

For 2022/23, there were 25 hospital admissions for asthma among children aged 0-9 years in Hull (numbers rounded to the nearest 10).

The rate of hospital admissions for diabetes has remained relatively constant over the period 2010/11 to 2022/23 at around 30 admissions per 100,00 population. However, the number of admissions are small and subject to year-on-year variability (see Small Numbers for more information). The rate was slightly higher at just over 40 admissions per 100,000 population for 2015/16 and twice as many admissions for 2021/22 with a rate of 60 admissions per 100,000 population. It is possible that these higher rates were related to one child or a small number of children being admitted multiple times during the financial year, but it could also represent random year-on-year variability.

For 2022/23, there were 10 hospital admissions for diabetes among children aged 0-9 years in Hull (numbers rounded to the nearest 10).