Young children whose families changed residences frequently during their first year of life may end up in the hospital more often than children who stay put in the same home, according to a recent Swansea University study.
Led by Professor Hayley Hutchings, Professor of Health Services Research at Swansea University’s Medical School, the research focused on what they suspect may be preventable emergency department visits for childhood ailments like ear infections, dehydration and dental problems. Problems like this, if properly treated, might not escalate to the point of needing hospital care, the researchers note in the journal Paediatrics.
Professor Hutchings (left), explains: “Moving home even once may result in severing of links with primary health care providers, which may mean that parents present to the emergency department more often when their child is ill or has been injured because they don’t have links to primary care in place anymore.
"Clinicians should try and engage with families as much as possible, particularly those who have a history of moving to try and ensure that relationships between frequently moving families and health care providers are maintained following moves”.
The researchers examined data from the Welsh Electronic Cohort for Children. Of the 237,842 children examined, a large majority (84.6%) never moved, 31,735 children (13.3%) moved once, and 4,993 (2.1%) moved twice or more. The greatest rate of potentially preventable hospitalisations for young children was between 1 and 2 years of age, and decreased in frequency with increasing age.
Most of the children in the study didn’t move at all when they were babies. Almost 32,000 of them (13%), moved once before their first birthdays. Another 2%, or almost 5,000 infants, moved at least twice.
Key research findings:
- Compared with no moves, children that moved home once in their first year of life were 14% more likely to visit the hospital for a potentially preventable problem.
- With at least two moves, the increased risk of preventable hospitalizations was 45% higher than for not moving at all.
- Children who moved more than twice were 44% more likely to have emergency department admissions for ear, nose and throat infections.
- Children who moved more than once were also 51% more likely to be admitted for dehydration or gastrointestinal problems, 61% more likely to have asthma admissions, and 58% more likely to visit the hospital for epilepsy or convulsions.
- Frequent movers were 33% more likely to have emergency department admissions for injuries and 30% more likely to visit the hospital for dental problems.
The study doesn’t prove that moving causes hospitalisations or that every emergency department admission could be avoided by good primary care, the study team cautions.
The authors acknowledge that poorer families are thought to move more often, and may be more likely to live in housing conditions that are conducive to respiratory infections and other illnesses. But Professor Hutchings states that although the study didn't ascertain the reasons for moving, they probably didn't relate just to poverty: "It may well be that families from more deprived communities may move more, but moving in itself is a modern phenomenon and is likely to be due to many factors including relationship splits, moves related to work or aspirations to move to better housing”.
In addition to having no information on reasons for moving, the authors of the research paper also noted that a residential move was based on parents registering a change of address with a healthcare provider, which may underestimate the number of moves. Another potential limitation was that the study contained no details regarding family structure.
Professor Hutchings and colleagues state that further research, including collecting qualitative data, is needed to understand the reasons behind residential mobility in early childhood and to identify these causal factors for families at risk. The hope is that this research might lead to interventions for randomized controlled trials.
The research paper, entitled, Residential Moving and Preventable Hospitalisations, can be viewed here.
- Thursday 9 June 2016 11.31 BST
- Thursday 9 June 2016 11.40 BST
- Catrin Newman