Admissions, prevalence and quality and safety outcomes for children with intellectual disability admitted to a tertiary paediatric healthcare organisation: A retrospective chart review

Ms Laurel Mimmo1,2, Associate Professor Reema Harrison3, Professor Joanne Travaglia4, Dr Nan Hu1, Associate Professor Sue Woolfenden1,2

1University of NSW, Randwick, Australia, 2The Sydney Children’s Hospitals Network, Randwick/Westmead, Australia, 3Macquarie University, Macquarie Park, Australia, 4University of Technology, Sydney, Sydney, Australia

Children with intellectual disability have higher healthcare utilisation than their peers, report poor experiences of care and subsequently have a heightened risk of avoidable harms every time they access tertiary healthcare. However, reliable methods to identify children with intellectual disability when they access hospital care are lacking both in the Australian context and internationally, limiting opportunities to enhance and improve healthcare experiences for these children.

A retrospective chart review of 1018 randomly selected patients admitted at least once for greater than 23 hours to one of the two tertiary children’s hospitals in Sydney, Australia, in 2017. Each record was manually interrogated to identify which children had documented evidence of intellectual disability or developmental delay. Data including patient demographics, number of admissions, length of stay, and reported clinical incidents for each patient were also extracted.

13.9% (n=190) of admissions were for children with intellectual disability; this group had a longer median length of stay than their peers (100.5 vs 79 hours, p= 0.001). Children with intellectual disability were more likely to come from a rural location (14% vs 8%, p= 0.012) and had more admissions with at least one incident compared to children without intellectual disability (14.7% vs 9.7%, p=0.06).

Children with intellectual disability experience inequities in quality and safety when admitted to hospital. Using methods to capture and include the quality and safety experiences of healthcare for children with intellectual disability can inform targeted improvements to healthcare delivery for all children in hospital.


Laurel Mimmo works in the Clinical Governance Unit at Sydney Children’s Hospital, Randwick, is a PhD candidate in Faculty of Medicine, UNSW and SPHERE translational research fellow. She has over 15 years’ clinical experience as a paediatric nurse. Laurel’s doctoral studies are exploring hospital experiences for children with intellectual disability.