Do adolescent inpatient wards make a difference? Findings from a national young patient survey.
There is little evidence to support the effectiveness of adolescent inpatient wards. These analyses test the hypotheses that nursing young people in adolescent wards improves aspects of quality of care and patient satisfaction compared with child or adult wards. Secondary analyses of the national English Young Patient Survey 2004 were weighted to take account of variations in hospital size and response rate. Participants included 8855 subjects aged 12 to 17 years. Ward types (adolescent, child, and adult) were compared. Patient-reported quality-of-care indicators included rating by young people of overall care, respect, safety, confidentiality, communication, team-working, noise, and leisure facilities. Logistic regression models were adjusted for gender, disability, and previous hospital admissions. Ten percent of 12- to 14-year-olds and 18% of 15- to 17-year-olds were nursed in an adolescent ward, 0.4% of 12- to 15-year-olds and 16% of 15- to 17-year-olds in an adult ward, with the remainder in a child ward. Compared with being in an adolescent ward, 15- to 17-year-olds were less likely to report excellent overall care in an adult ward and less likely to report feeling secure, having confidentiality maintained, feeling treated with respect, confidence in staff, appropriate information transmission, appropriate involvement in own care, and appropriate leisure facilities. Compared with being in an adolescent ward, 12- to 14-year-olds were less likely to report excellent overall care in a child ward and less likely to report feeling involved in their own care. Dedicated adolescent inpatient wards improve aspects of quality of care for young people compared with child or adult wards, particularly for older adolescents. These data support the continued development of adolescent wards in larger general hospitals and children's hospitals.