Epidemiology of children admitted to the Dutch burn centres. Changes in referral influence admittance rates in burn centres

BackgroundIn the Beverwijk Burn Centre a remarkable rise has been noted in the number of paediatric admissions since 2000. To investigate if this is a national trend and, if so, what may have caused it, a retrospective epidemiological study has been undertaken.Materials and methodsThe databases of the three Dutch burn centres were combined. Data on the population at risk for admission in a burn centre and data on burns related hospital admissions were added. Two age groups, 0–4 years and 5–17 years and two time periods, 1995–1999 and 2000–2007, were compared.ResultsThe mean number of paediatric admissions in the Dutch burn centres per year increased by 44.0% and 44.3% for the younger children (0–4 years) and the older children (5–17 years), respectively, whereas the number of paediatric burn admissions in other hospitals in the Netherlands decreased. The percentage of children that was referred from other hospitals increased in both age groups, and for the younger children this was significant.ConclusionThere has been a shift in paediatric burn care towards a greater volume of admissions in specialized burn care of especially young children with less severe burns. A possible explanation for the increased number of referred children may be the introduction of the EMSB course in 1998, since EMSB guidelines dictate stricter and generally accepted referral criteria.