wealth gap in child critical care

[Amby 490]

Children from the most deprived homes are more likely to need an intensive care bed than their wealthier counterparts, say researchers.

The largest UK audit, studying 40,000 cases, found poor children were twice as likely to be admitted.

But the audit, published in Archives of Disease in Childhood, found their chances of survival were just as good. However, children from affluent south Asian families were a third more likely to die.

The study was conducted by specialists from the universities of Leeds and Leicester, using a national database that collects details of all children taken into paediatric intensive care units in the UK.

During a four-year period, data for England and Wales revealed that the average child had a one in 1,000 chance of needing critical care.

When the 40,000 were split into five groups based on a "deprivation rating" given to the communities in which they lived, those in the least deprived areas were only half as likely to be admitted as those in the most deprived areas.

Dr Roger Parslow, one of the study leaders, said that the finding that less affluent children were more likely to be admitted, was in line with other information about the impact of "health inequalities" on both child and adult health.

He added: "Even though paediatric intensive care units admit more children from poorer backgrounds, those children are not more likely to die than someone from a more affluent group.

"There is clearly no inequality in the treatment children receive based on their social background."

South Asian mystery

However, the higher mortality among the children of wealthier south Asian families could not be explained so easily, he said, and he called for more research.

"We should be looking at these children in more detail to see if there are other interventions which may help them."

Dr Ian Jenkins, president of the Paediatric Intensive Care Society, said that the finding that, in most cases, children from less affluent families fared just as well as children of rich families was "reassuring".

He said: "There are lots of reasons why children from poorer families are more likely to be admitted to intensive care units. "We know that these families tend to access health services in a different way, and it's possible that by the time they present at primary care with a problem, they are sicker than other children, and may be more likely to need intensive care."

http://news.bbc.co.uk/1/hi/health/7795319.stm