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Pediatric observation status beds on an inpatient unit: an integrated care model.
Pediatr Emerg Care. 2004 Jan; 20(1):17-21.PE

Abstract

OBJECTIVES

Describe the usage of observation status (OS) beds on a pediatric inpatient unit and identify diagnoses likely to be successfully discharged compared to those requiring formal inpatient admission.

METHODS

Retrospective chart review of all patients (0-18 years) transferred to pediatric OS beds from the emergency department (ED) between April 1, 1997 and April 30, 1999. Outcome measures consisted of time interval between ED triage and arrival to an OS bed, total hours in observation, and need for admission or transfer. Using relative risk (RR), we compared admission rates for the 4 most common diagnoses.

RESULTS

We studied 800 transfers to pediatric OS beds. Asthma (27%), gastroenteritis/dehydration (16%), infectious disease (12%), and bronchiolitis (9%) were the 4 most common diagnoses. There were 597 patients (75%) successfully discharged from observation and 174 (22%) required inpatient admission. Seventeen patients (2%) were transferred to a psychiatric facility and 12 patients (1%) were transferred to a tertiary care center for further evaluation and treatment. Compared to gastroenteritis/dehydration, patients with asthma were just as likely to be admitted/transferred (RR 1.05, 95% CI, 0.87-1.27), those with an infectious disease were 1.3 times more likely to be admitted/transferred (RR 1.35, 95% CI, 1.0-1.83), and those with bronchiolitis were 2 times more likely to be admitted/transferred (RR 1.92, 95% CI, 1.34-2.74).

CONCLUSIONS

We describe the usage of OS beds in a community hospital that we believe can be a successful model for the care of pediatric patients. Future studies are needed to delineate the clinical characteristics of patients that would benefit from this care delivery model.

Authors+Show Affiliations

Department of Pediatrics, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA. crocetti@jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

14716160

Citation

Crocetti, Michael T., et al. "Pediatric Observation Status Beds On an Inpatient Unit: an Integrated Care Model." Pediatric Emergency Care, vol. 20, no. 1, 2004, pp. 17-21.
Crocetti MT, Barone MA, Amin DD, et al. Pediatric observation status beds on an inpatient unit: an integrated care model. Pediatr Emerg Care. 2004;20(1):17-21.
Crocetti, M. T., Barone, M. A., Amin, D. D., & Walker, A. R. (2004). Pediatric observation status beds on an inpatient unit: an integrated care model. Pediatric Emergency Care, 20(1), 17-21.
Crocetti MT, et al. Pediatric Observation Status Beds On an Inpatient Unit: an Integrated Care Model. Pediatr Emerg Care. 2004;20(1):17-21. PubMed PMID: 14716160.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pediatric observation status beds on an inpatient unit: an integrated care model. AU - Crocetti,Michael T, AU - Barone,Michael A, AU - Amin,Diane Dritt, AU - Walker,Allen R, PY - 2004/1/13/pubmed PY - 2004/5/1/medline PY - 2004/1/13/entrez SP - 17 EP - 21 JF - Pediatric emergency care JO - Pediatr Emerg Care VL - 20 IS - 1 N2 - OBJECTIVES: Describe the usage of observation status (OS) beds on a pediatric inpatient unit and identify diagnoses likely to be successfully discharged compared to those requiring formal inpatient admission. METHODS: Retrospective chart review of all patients (0-18 years) transferred to pediatric OS beds from the emergency department (ED) between April 1, 1997 and April 30, 1999. Outcome measures consisted of time interval between ED triage and arrival to an OS bed, total hours in observation, and need for admission or transfer. Using relative risk (RR), we compared admission rates for the 4 most common diagnoses. RESULTS: We studied 800 transfers to pediatric OS beds. Asthma (27%), gastroenteritis/dehydration (16%), infectious disease (12%), and bronchiolitis (9%) were the 4 most common diagnoses. There were 597 patients (75%) successfully discharged from observation and 174 (22%) required inpatient admission. Seventeen patients (2%) were transferred to a psychiatric facility and 12 patients (1%) were transferred to a tertiary care center for further evaluation and treatment. Compared to gastroenteritis/dehydration, patients with asthma were just as likely to be admitted/transferred (RR 1.05, 95% CI, 0.87-1.27), those with an infectious disease were 1.3 times more likely to be admitted/transferred (RR 1.35, 95% CI, 1.0-1.83), and those with bronchiolitis were 2 times more likely to be admitted/transferred (RR 1.92, 95% CI, 1.34-2.74). CONCLUSIONS: We describe the usage of OS beds in a community hospital that we believe can be a successful model for the care of pediatric patients. Future studies are needed to delineate the clinical characteristics of patients that would benefit from this care delivery model. SN - 1535-1815 UR - https://www.unboundmedicine.com/medline/citation/14716160/Pediatric_observation_status_beds_on_an_inpatient_unit:_an_integrated_care_model_ L2 - https://doi.org/10.1097/01.pec.0000106238.72265.5f DB - PRIME DP - Unbound Medicine ER -