The reasons for admission of children to paediatric beds and the appropriateness of those admissions were investigated by a retrospective study of admission notes by two paediatricians. Approximately 3% and 9% of the admissions according to assessor, were for purely social reasons and the remainder for predominantly medical reasons. There were a number of admissions for whom the assessors were unable to justify admission. Assessor 1 considered that 20% and assessor 2 15%, of those studied could have been managed without admission. Agreement over individual cases between assessors was poor but significant. The assessors agreed that admission was appropriate in 74% and inappropriate in 8% of cases. In the remaining 18 cases, the assessors did not agree on the need for admission. It is suggested that there is a need for local specialty specific admission policies to ensure cost-effective use of facilities.
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