Considering kids in an ageing population

Child for Gary Freed internetLike most developed countries, Australia’s population is ageing.  Because of this, plenty of attention is being focused nationally on ensuring the healthcare needs of adults and seniors will be provided for into the future.

But what does this mean for the health of Australia’s children?  This is a question The Royal Children’s Hospital (RCH) is determined to answer, through a collaborative research project with Professor Gary Freed from The University of Melbourne School of Population and Global Health.

Professor Freed says that while the proportion of adults in Australia is growing, we mustn’t forget that the number of children in Australia is also growing. 

“Children may represent a smaller proportion of the overall population than they did, say, 20 years ago, but their absolute number is still increasing.  What’s more, we have more children alive today with chronic illness than we’ve ever had, because premature babies are saved and kids with heart disease are saved,” Professor Freed says.

Professor Freed is heading up research across four different Victorian hospitals – the Royal Children’s, Austin, Northern and Sunshine hospitals – with support from the Victorian Department of Health and three Medicare locals, to understand the healthcare habits of families with children, and determine where the system may be failing families and how it can be improved.

“The RCH Emergency Department (ED) is experiencing unprecedented demand, with 10 per cent more patients presenting to Emergency this year compared to last year.  Other hospitals in Victoria are experiencing similar increases in paediatric ED attendances,” said Professor Freed.

“We have all sorts of anecdotal evidence for why this increase is occurring – lack of GP appointment availability, a belief that hospital staff are better trained to care for children, a tendency for on-call nursing services to refer paediatric patients to hospitals, and a belief that specialist clinic waits are too long – but the jury is out on how accurate this evidence is.

“The issue of ED volume at the RCH is very real and becoming increasingly critical with regard to being able to provide timely and efficient care to children who need it.  But ‘crisis’ responses are not helpful.  Too often we see hasty, irrational healthcare policy changes introduced on the basis of unproven evidence,” he said.

Professor Freed is bucking the trend and doing something that hasn’t been done before: he’s visiting EDs and asking parents “Why are you here?”

The three-year study is also investigating the impact of the ageing population on the care children receive from GPs. 

“We need to get a better understanding of the experience and competency of GP registrars (junior GPs) nationwide with regard to the care of children.  Are they getting enough exposure to children during their training?  Are they experiencing enough extended consultations involving children with chronic illness?” Professor Freed said.

Data will take another 12 months to collect and analyse by a research team comprising GPs, emergency physicians and paediatricians. 

“Once the results are in, Victoria can begin to make evidence-based policy changes to paediatric healthcare, rather than fixing a problem we think exists, but actually doesn’t,” Professor Freed says.

“Children are our future and we can’t just pay lip service to them.  We need to develop the right policies for everyone, children and adults alike,” he said.

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