A prospective cohort study comparing hospital admission for gastro-enteritis with home management

Child Care Health Dev. 2005 Sep;31(5):555-62. doi: 10.1111/j.1365-2214.2005.00550.x.


Objectives: To compare physical and psychological outcomes in children presenting at Accident and Emergency Departments (A&E), diagnosed with gastro-enteritis and admitted to hospital with those of a similar age, sex and severity of illness discharged home. The physical and psychological well-being of children in these two groups, in the month after the episode, were compared as was further use of health care services.

Design: A prospective cohort study.

Methods: A comparison of 116 children aged 1-6 years with gastro-enteritis, presenting at A&E over a 6 months period. Admitted children were compared with children discharged, of a similar age, sex and illness severity (triage score) with follow-up at 1 week and 1 month. Clinical history, psychosocial factors, investigations and outcomes were recorded at presentation and physical, psychological and family outcomes at 1 week and 1 month.

Results: Of 116 children, 112 (97%) completed the study (56 in each group). No differences were detected in psychosocial factors, socio-economic status, family factors, time of arrival at A&E or waiting times. Parental perception of illness was greater in the admitted group (P < 0.005), but was recorded after the decision on admission was made. At 1 week follow-up admitted children had increased separation anxiety compared with children who were discharged (P < 0.05), but this difference disappeared at 1 month. Clinical outcomes were the same for both groups, although admitted children had more investigations (91% vs. 39%). Parents were equally satisfied with their child's treatment, but one-third of children in both groups sought further consultation with a health professional in the following week.

Conclusions: There is no statistically significant difference in socio-demographic data, time of arrival at A&E, waiting times, clinical and psychosocial outcomes in children with acute gastro-enteritis admitted to hospital compared with a group of children of similar age, gender and severity of illness managed at home. However, parents seek reassurance and follow-up of acutely ill children, even if the child is admitted to hospital, which has service and resource implications.

Publication types

  • Comparative Study

MeSH terms

  • Child
  • Child Behavior / psychology
  • Child, Preschool
  • Emergencies
  • Female
  • Gastroenteritis / therapy*
  • Home Care Services / organization & administration*
  • Hospitalization*
  • Humans
  • Infant
  • Male
  • Parents / psychology
  • Patient Satisfaction
  • Prospective Studies
  • Referral and Consultation
  • Treatment Outcome