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• W4384566678 abstract "<h3>Objectives</h3> The transition of children and young people with chronic kidney disease (CKD) from paediatric to adult healthcare has been associated with poor outcomes,¹ but there has been no recent assessment of these at a population level or how different sub-groups are impacted. This study aims to assess sociodemographic inequalities in the change in unplanned secondary care use before and after transfer to adult secondary care services for young people with CKD in England. <h3>Methods</h3> A cohort of individuals diagnosed with CKD as children who transitioned to adult care was constructed from routine healthcare administrative data in England (Hospital Episode Statistics²). Age at transition was estimated via the last paediatric appointment.³ The primary outcome was the number of emergency secondary care admissions and accident and emergency attendances per person per year, which was compared in the 4 years before and after transition. Comparison of the outcomes via sociodemographic data was assessed through negative binomial regression with random effects. <h3>Results</h3> There were 4,505 individuals in the cohort. Controlling for age, birth-year, age at transition, region and socio-demographic factors, transition was associated with a significant decrease in emergency secondary care admissions (IRR 0.75, 95% CI 0.64–0.88) and no change in A&E attendances (IRR 1.10, 95% CI 0.95–1.27). For both types of care there were significantly higher overall rates of emergency secondary care use in female sex, non-white ethnicities and higher index of multiple deprivation and evidence for effect modification between these factors and transition. <h3>Conclusions</h3> There were sociodemographic inequalities in emergency secondary care usage in this cohort across the transition period, independent of age, with some variation in trends between data on secondary care admissions and A&E use. Such inequalities are likely to be multifactorial in origin, and explanations could include differences in the types and severities of CKD among these groups, but importantly, could represent differential meeting of care needs. Further validated prospective studies are needed to evaluate trends in CKD populations and investigate drivers and solutions to such inequalities. <h3>References</h3> Watson AR, <i>et al</i>. Transition from pediatric to adult renal services: a consensus statement by the international society of nephrology (ISN) and the international pediatric nephrology association (IPNA). <i>Kidney International</i> 2011;<b>80</b>(7):704–707. Herbert A, <i>et al</i>. Data Resource Profile: Hospital Episode Statistics Admitted Patient Care (HES APC). <i>International Journal of Epidemiology</i> 2017;<b>46</b>(4):1093–1093i. Jarvis S, <i>et al</i>. Estimation of age of transition from paediatric to adult healthcare for young people with long term conditions using linked routinely collected healthcare data. <i>International Journal of Population Data Science Journal</i> 2021;<b>6</b>(1):1685." @default.
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• W4384566678 date "2023-06-19" @default.
• W4384566678 modified "2023-10-16" @default.
• W4384566678 title "159 Inequalities in emergency care use in young people with chronic kidney disease across transition from paediatric to adult care" @default.
• W4384566678 doi "https://doi.org/10.1136/archdischild-2023-rcpch.123" @default.
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