Many teen patients placed in adult wards

Study highlights adolescent care deficiencies
  • Deborah Condon

More attention needs to be paid to the specific healthcare needs of adolescents, a new study has shown.

According to the findings, many teenage patients are being admitted to wards that are not appropriate for their age and further investment is needed to properly care for this ‘valuable yet vulnerable generation'.

Researchers from University Hospital Limerick and the University of Limerick set out to assess the healthcare needs of adolescent patients. Currently in Ireland, all medical patients are supposed to have their care overseen by a paediatrician up to the age of 16 years (or 18 if there are mental health problems).

"The 2016 Census reports that there are now 404,540 people between the ages of 12 and 18 years living in the Republic of Ireland. Of these, over 173,000 inhabit that twilight zone of 14-16 years of age. This ‘seventh age of childhood' is the least understood, least researched and therefore least resourced of all developmental ages," the researchers noted.

As a result, their study focused on children in the 14-16 age group.

They looked at all presentations by this age group to six hospitals in the Limerick, Clare and north Tipperary region over a 10-year period. During this time, there were 10,992 hospital admissions, 41,456 outpatient appointments and an average of 1,847 attendances per year at University Hospital Limerick's Emergency Department (ED).

However, the study found that among the almost 11,000 hospital admissions, just 17% were admitted to age-appropriate wards. The vast majority were admitted to adult surgical and medical wards.

Furthermore, just 11% were admitted under the care of a paediatrician, and of the 41,000+ outpatient appointments, just 19% were reviewed by a paediatrician.

"Undoubted deficiencies in the provision of an optimum hospital setting for adolescents were highlighted in our study. Of note, less than one-fifth of patients were admitted to an age-appropriate ward, and only 11% of patients were cared for by a paediatrician during their inpatient stay. These striking statistics highlight the scarcity of dedicated resources currently available to effectively meet the healthcare needs of this special population and demonstrate a pressing need for further investment in this area," the researchers said.

They acknowledged that the provision of adolescent-focused care presents unique challenges, which ‘differ distinctly from those of children and adults'.

"To meet these challenges, adolescent medicine has emerged as a subspecialty from paediatric and adult medicine, however to date no such specialist has been appointed in Ireland.

"Building an effective workforce of highly-skilled adolescent health professionals who understand the specific biological, psychological, behavioural, social, and environmental factors that impact the health of adolescents is critical to engage youths in healthcare and address complex psychosocial needs that may otherwise go unnoticed," the researchers insisted.

They noted that the development of adolescent inpatient units in other countries, such as Australia, have proven very successful, as these units provide ‘developmentally appropriate' healthcare to young people.

The researchers pointed out that expenditure on adolescent healthcare training in Ireland has so far been limited and as a result, this population has largely been neglected.

They also noted that the stereotypical media portrayal of young people is largely negative and simplistic, often focusing on anti-social behaviour and criminality. However, they insisted that the majority of Irish adolescents ‘undisputedly make a valuable and positive contribution to our society'.

"Growing recognition of the crucial roles adolescents play in today's society has spurred an expanding global movement to address the healthcare requirements of this unique cohort.

"The Irish healthcare agenda needs to be advanced to ensure the highest attainable standards for health and wellbeing for this valuable, yet vulnerable generation. Further investment will help shape the fledgling discipline of adolescent health in Ireland," they added.

This study is published in the Irish Medical Journal.


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