G128(P) Towards utopian adolescent healthcare

Background Adolescence, the seventh age of childhood is the least understood, least researched and therefore least resourced of all developmental ages. Health challenges of adolescents differ distinctly from those of children and adults. To meet these challenges adolescent medicine has emerged as a subspecialty from paediatric and adult medicine. The availability and effective provision of appropriate services are essential to cater for the diverse needs of this population. Aims This study wishes to highlight the healthcare needs of the 18 387 adolescents aged 14–16 years catered for by our hospital group with a view to investigating the services they require and environmental appropriateness of their care. Methods This retrospective descriptive study examined details of hospitalisations, outpatient consultations and emergency department attendances for patients aged 14–16 years presenting to our hospital group from 01.07.2006–01.07.2016. Hospital patient databases were used to examine patient demographic details, reason for inpatient stay, comorbidities, duration of stay, admitting speciality, inpatient ward, clinic attendance and clinic speciality. Results A total of 10 992 hospital admissions, 41 456 outpatient appointments and 5539 emergency department attendances were identified for patients aged 14–16 within our 10 year study period. Patients were housed in Paediatric Wards in 1,873 (17.0%) cases, Maternity Wards in 240 (2.2%) cases, Surgical wards in 3,201 (29.1%) cases, Medical wards in 1,669 (15.2%) cases and mixed or other wards in 4,009 (36.5%) cases. Patients were admitted under specialities as follows; Surgeons 55.88%, Adult Physicians 28.5%, Obstetricians/Gynaecology 3%, Paediatricians 11.3% and others 1.2%. An average 6.5 beds were used per day to house adolescents aged 14–16 years. Average length of in hospital stay was 2.1 days. Outpatient appointments were categorised as Paediatrics in 7,828 (18.9%) cases. Of the other 25 departments identified, the most prevalent in order of frequency were; Orthopaedics, Otorhinolaryngology, Maxillofacial and Dermatology. Conclusion Our study found 1 hospital bed/day was required for every 2828 adolescents. Only 17% were admitted to wards with other young people. The appointment of an appropriately resourced physician with special interest in Adolescent Medicine would lead to the creation of an age appropriate environment for patients at this sensitive developmental age and a more standardised and structured approach to care.