Article Text
Abstract
Aims There is a statutory requirement to review all child deaths as part of the safeguarding children guidance. The aim of this cohort study is to collate and evaluate child death data from all Child Death Overview Panels within the Yorkshire and Humber region to inform strategic planning, justify funding, and ultimately improve the care provided to children.
Methods Retrospective cohort study. Data audited from all 14 CDOPs in the region. Descriptive analysis performed using SPSS. The dataset included: 3 full years of CDOP data (2013/2014 – 2015/16), all child deaths (expected and unexpected), age (0–17 inclusive), gender, ethnicity, partial postcode, place of death and category of death following review. Ethical approval not required as audit and no patient identifiable data collected. Missing data excluded from analysis on a pairwise basis.
Results Over the study period there were 1221 deaths, with an average mortality rate of 407 deaths pa (total child population=1.1 million, 3.5 deaths/10000 children). The major causes of death were perinatal/neonatal events, and chromosomal, genetic and congenital anomalies; Combined these account for 60% (n=712/1183) of the dataset. ‘Expected’ deaths accounted for 64% (n=730/1149) of all child deaths. Place of death for expected deaths=Hospital deaths: 77% (n=564) Home: 9% (n=67), Hospice: 13% (n=91). When ethnicity data analysed for place of death (excluding neonatal and unexpected deaths), a greater proportion of white British children (n=201) died at home (16%, n=33) or within a hospice (23%, n=47) when compared to Asian children (Home: 12%, n=14; Hospice: 9%, n=10); Chi-squared 15.07, p=0.002.
Conclusions
Place of Death (POD) key quality indicator for EOL care. Limited evidence preferred POD in paediatrics.
Ethnicity appears to affects POD.
Oncology patients are more likely than children dying from other causes to die at home. This is likely due to the provision of POON services.