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Variation in healthcare for children and young people with cerebral palsies: a retrospective multi-centre audit study

Lookup NU author(s): Peter Tennant, Professor Judith Rankin

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Abstract

AIM: To explore the provision of care, and variations in care, for children and young people with cerebral palsies registered with the population-based North of England Collaborative Cerebral Palsy Survey (NECCPS). METHODS: Retrospective multi-centre record audit of 389 children, born 1995-2002. Data collected on: cranial magnetic resonance imaging (MRI), hip and spine surveillance and management, pain presence and management. Variations over time, 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, Middlesborough, Redcar and Cleveland), and by socio-economic status (estimated from the Index of Multiple Deprivation 2004) were estimated by generalised estimating equations. RESULTS: There was significant variation between districts in access to MRI (p<0.0001), orthopaedic surgeons (p=0.005), recording state of spine (p<0.0001), and discussions about pain (p<0.0001). 57% (95% CI: 52-62) had evidence of a reported MRI brain scan, the proportion of which increased over time (p<0.0001). 67% (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 socio-economic status (p=0.04). INTERPRETATION: The provision of care for children with cerebral palsies in the North of England varies between districts. Internationally agreed, evidence-based standards are urgently needed to ensure more equitable healthcare and improved outcomes for all.


Publication metadata

Author(s): Horridge K, Tennant PWG, Balu J, Rankin J

Publication type: Article

Publication status: Published

Journal: Developmental Medicine & Child Neurology

Year: 2015

Volume: 57

Issue: 9

Pages: 844-851

Print publication date: 01/09/2015

Online publication date: 24/03/2015

Acceptance date: 24/01/2015

ISSN (print): 0012-1622

ISSN (electronic): 1469-8749

Publisher: Wiley-Blackwell Publishing Ltd

URL: http://dx.doi.org/10.1111/dmcn.12740

DOI: 10.1111/dmcn.12740


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