Objectives To develop a method for calculating agespecific hospital catchment populations (HCPs) for children
and young people (CYP) in England. To show how these
methods allow geographical variation in hospital activity to
be investigated and addressed more effectively.
Design Retrospective, secondary analysis of existing
national datasets.
Setting Inpatient care of CYP (0-18 years) in England.
Participants Hospital Episode Statistics (HES) data
were accessed for all inpatient admissions (elective and
emergency) for CYP from birth to 18 years, 364 days,
for 2011/2012–2014/2015. In 2014/2015, 857 112
admissions were analysed, from an eligible population of
approximately 11.9 million CYP.
Outcome measures For each hospital Trust, the
catchment population of CYP was calculated; Trustlevel admission rates per thousand per year were then
calculated for admissions due to (1) any diagnostic code,
(2) primary diagnosis of epilepsy and (3) epilepsy listed as
primary diagnosis or comorbidity.
Results Estimated 2014/2015 HCPs for CYP ranged from
268 558 for Barts Health NHS Trust to around 30 000 for
the smallest acute general paediatric services and below
10 000 for many Trusts providing specialist services. As
expected, the composition of HCPs was fairly consistent
for age breakdown but levels of deprivation varied
widely. After standardising for population characteristics,
admission rates with a primary diagnosis of epilepsy
ranged from 14.3 to 157.7 per 100 000 per year (11.0-fold
variation) for Trusts providing acute general paediatric
services. All-cause admission rates showed less variation,
ranging from 4033 to 11 681 per 100 000 per year (2.9-
fold variation).
Conclusions Use of age-specific catchment populations
allows variation in hospital activity to be linked to specific
teams and care pathways. This provides an evidence base
for initiatives to tackle unwarranted variation in healthcare
activity and health outcomes.