Abstract
The upper age limit for Paediatric Orthopaedic referrals and admissions has recently been increased from 14 to 16 years. This has many benefits but will change the volume of cases as well as influencing both case mix and the resources required. We analysed the operations and admissions in our department for the year preceding and succeeding the change in age limit in order to evaluate the impact on the service. Our outcome measures were number of trauma and elective cases treated, time spent operating, case mix and cost to the service.
Admission and operative logs for the aforementioned years were analysed to obtain number of admissions, length of stay and operative intervention as well as time in theatre. National reference data from Information Services Division Scotland was used in order to get accurate costs for theatre time and inpatient stays in our hospital.
Results showed an increase in total number of cases from 438 per year to 499. Trauma cases increased from 133 (30.4%) to 202 (40.5%). Of these, 35 (17.3%) were over 14 years. The number of children over 14 years which had an operation, doubled from 51 to 102. Hours spent operating increased from 681.25 to 830.25. The percentage time operating on those aged over 14 increased from 13.2% to 23.8%. Theatre costs increased by £148005 (21.9%) to £822442.50.
The change in age limit has significantly increased case variety and numbers. This has significant financial implications and as such needs adequately resourced to ensure high quality clinical care.
