Coin-cidence? Have cashless payments reduced the incidence of kids eating coins? A study of UK Hospital Episode Statistics.

Researchers from the UK’s National Health Service have identified a possible unexpected benefit of the rise in contactless payments: fewer children are turning up at hospitals after swallowing coins, according to Finextra.

In a paper entitled ‘Coin-cidence? Have cashless payments reduced the incidence of upper aerodigestive foreign body insertion‘ the authors track the rise of contactless against a fall in foreign body (FB) retrieval procedures involving the alimentary tract, respiratory tract and nasal cavity.

Insertions of nasal and oral foreign bodies (FB) are common presentations in the emergency department, with coins frequently implicated among paediatric populations. Contactless payments were first introduced in the UK in 2007, and cash payments significantly declined from 2012. This study aims to explore the potential implications of increasing contactless payments on FB ingestion.

UK Hospital Episode Statistics (HES) were reviewed between 2000 and 2022. All FB retrieval procedures involving the alimentary tract, respiratory tract and nasal cavity were included. Regression analysis was performed to assess trends in the incidence of FB ingestion before and following the transition to cashless payments in 2012.

Following the decline in cash payments in 2012, the frequency of alimentary tract FB removal procedures decreased significantly by 27.78 procedures per year (p < 0.001). Similarly, respiratory FB removal procedure decreased by 4.83 per year (p = 0.009) and nasal cavity FB removal procedures decreased by 52.82 per year (p < 0.001).

Coins are implicated in more than 75% of swallowed FBs in children under the age of six, say he researchers. A review of endoscopies for FBs shows that 66% of the ingested FBs were coins. They are frequently ingested because of their thin, round shape and easy accessibility.

The fall could help save the NHS significant sums, with a recent study showing that the cost of FB removal is approximately £2,880,148 a year.

Conclusions

This study suggests a statistically significant decline in the number of procedures for removal of FB performed in the UK from 2012. „Although this relationship is multifactorial, our data suggest an association between the introduction of contactless payments and a reduction in the number of FB retrieval procedures from the of upper aerodigestive tract.” – according to the researchers.

The researchers concludes: „Following the increase in cashless payments identified in 2012, we report a statistically significant reduction in the frequency of alimentary FB removal procedures. This study implies this change in consumer behaviour may have contributed to the multifactorial reduction in the incidence of FB removal procedures.

Changes in public health policies, education programmes targeting children and parents, and shifts in population behaviours unrelated to payment methods may all play a part. 

Contactless and cashless payment systems have changed our spending habits, with many people no longer choosing to carry physical cash. Although this may have impacted the incidence of FB coin ingestion in children, we acknowledge such trends are likely multifactorial.”