General Characteristics and Activity of Emergency Department Short-Stay Units in Spanish Hospitals

Ferre, C.; Llopis, Ferrán; Martín‐Sánchez, Francisco Javier; Sempere, Gonzalo; Llorens, Pere; Navarro, Carmen; Martínez-Ortiz, Mikel; Juan, Antonio; Sanpedro, Francesc; Guardiola, Josep M.; Guzmán, Marta; Álvarez, Antonia; Arranz, M.; Daza, Manuel; Cortés, Emilia Barrot; Pérez, Ví­ctor; Rua, Ma Aurora; Serra, Pere; Guerrero, Federico; Núñez, José Carlos; llull, José A.; Almela, Amadeo; Anduiza, Juan; Martı́n, Alfonso; Juarez, R.; Gil, Javier; Ferreira, Antonio Alberto de Medeiros; Lapuerta, Luis; Castro, Carlos; Porras, Antonio R.; Valentín, Pedro M.

doi:10.1016/j.jemermed.2017.01.045

Cited by 5 publications

(14 citation statements)

References 6 publications

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“…This transfer rate to the conventional ward is higher than that reported for alternative SSUs, which has been <10%. 14,16 Our results also agree with previous data showing that patients admitted at SSU but transferred to another inhospital ward have greater LOS than patients admitted and discharged from SSU or admitted and discharged from another in-hospital ward. 20,22 Therefore, the greater LOS of cardiology patients admitted at SSU seems to be related to the high proportion of patients transferred to the conventional ward or ICU.…”

Section: Discussionsupporting

confidence: 92%

“…Given the high prevalence of cardiology patients at SSU, 14,16 our findings provide novel background to the idea that in-hospital health services focused on cardiology may need re-evaluation following SSU opening at a general hospital.…”

Section: Discussionmentioning

confidence: 84%

“…Together, these findings suggest that SSU opening modified in-hospital indicators, particularly at CARD, and changed the characteristics of hospitalized cardiology patients. Given the high prevalence of cardiology patients at SSU, 14,16 our results provide novel background to the idea that in-hospital health services focused on cardiology may need re-evaluation following SSU opening at a general hospital.…”

Section: Discussionmentioning

confidence: 85%

“…[11][12][13] Most studies evaluating the effects of SSU on health care have focused on ED indicators. [13][14][15] Conversely, some lines of evidence, albeit scarce, have suggested that SSUs may also influence in-hospital indicators. In this regard, reductions in elective admissions and contradictory effects on in-hospital length of stay (LOS) after SSU opening have been reported.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10]15 Due to their great number of ED visits, patients with cardiovascular diseases are usually admitted at SSUs. 14,16 This raises the assumption that the demand for in-hospital cardiology services, particularly at general hospitals, might be affected by SSU opening. However, most studies focusing on the effects of SSUs on hospital indicators of cardiovascular diseases have been restricted to specific conditions, such as heart failure or acute coronary syndrome, [17][18][19] and hitherto no study has comprehensively evaluated the impact of SSU opening on in-hospital indicators and characteristics of patients under care of cardiology services at a general hospital.…”

Section: Introductionmentioning

confidence: 99%

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Impact of emergency short‐stay unit opening on in‐hospital global and cardiology indicators

Cirillo

Freitas

Kitaka

et al. 2021

Evaluation Clinical Practice

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Rationale, aims and objectives: Emergency short-stay unit (SSU) alleviates emergency department (ED) overcrowding, but may affect in-hospital indicators. Cardiology patients comprise a substantial part of patients admitted at SSU. This study evaluated whether SSU opening differentially modified in-hospital indicators at a whole general hospital and at its cardiology division (CARD). Methods: We retrospectively analysed indicators based on 859 686 ED visits, and 171 547 hospital admissions, including 12 110 CARD admissions, from 2007 to 2018 at a general tertiary hospital, and compared global ED indicators and in-hospital indicators at the hospital and CARD before (2007-2011) and after (2011-2018) SSU opening. Results: After SSU opening, monthly ED bed occupancy rate decreased (mean ± SD 200 ± 18% vs 187 ± 22%; P < .001) and in-hospital admissions from ED increased at the hospital (median [interquartile range] 460 [81] vs 524 [41], P < .001) and CARD (50 [12] vs 54 [12], P = .004). In parallel, monthly in-hospital elective admissions decreased at CARD (34 [18] vs 28 [17], P = .019), but not at the hospital (712 [73] vs 700 [104], P = .54). Average length of stay (LOS) increased at both hospital (8.5 ± 0.3 vs 8.7 ± 0.4 days, P < .001) and CARD (9.2 ± 1.5 vs 10.3 ± 2.3 days, P = .002) after SSU opening, but percent admissions at SSU showed a direct relationship with LOS solely at CARD. Furthermore, cardiology patients admitted at SSU had greater LOS, prevalence of coronary heart disease and age than those admitted at the conventional cardiology ward.Conclusions: SSU opening improved ED crowding, but was associated with changes in in-hospital indicators, particularly at CARD, and in the characteristics of hospitalized cardiology patients. These findings suggest that in-hospital cardiology services may need re-evaluation following SSU opening at a general hospital.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Impact of emergency short‐stay unit opening on in‐hospital global and cardiology indicators

Cirillo

Freitas

Kitaka

et al. 2021

Evaluation Clinical Practice

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Emergency department direct discharge compared to short-stay unit admission for selected patients with acute heart failure: analysis of short-term outcomes

Sánchez-Marcos¹,

Jacob

Llorens

et al. 2023

Intern Emerg Med

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Short stay unit (SSU) is an alternative to conventional hospitalization in patients with acute heart failure (AHF), but the prognosis is not known compared to direct discharge from the emergency department (ED). To determine whether direct discharge from the ED of patients diagnosed with AHF is associated with early adverse outcomes versus hospitalization in SSU. Endpoints, defined as 30-day all-cause mortality or post-discharge adverse events, were evaluated in patients diagnosed with AHF in 17 Spanish EDs with an SSU, and compared by ED discharge vs. SSU hospitalization. Endpoint risk was adjusted for baseline and AHF episode characteristics and in patients matched by propensity score (PS) for SSU hospitalization. Overall, 2358 patients were discharged home and 2003 were hospitalized in SSUs. Discharged patients were younger, more frequently men, with fewer comorbidities, had better baseline status, less infection, rapid atrial fibrillation and hypertensive emergency as the AHF trigger, and had a lower severity of AHF episode. While their 30-day mortality rate was lower than in patients hospitalized in SSU (4.4% vs. 8.1%, p < 0.001), 30-day post-discharge adverse events were similar (27.2% vs. 28.4%, p = 0.599). After adjustment, there were no differences in the 30-day risk of mortality of discharged patients (adjusted HR 0.846, 95% CI 0.637–1.107) or adverse events (1.035, 0.914–1.173). In 337 pairs of PS-matched patients, there were no differences in mortality or risk of adverse event between patients directly discharged or admitted to an SSU (0.753, 0.409–1.397; and 0.858, 0.645–1.142; respectively). Direct ED discharge of patients diagnosed with AHF provides similar outcomes compared to patients with similar characteristics and hospitalized in a SSU.

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Activity-based pricing and financial performance in Hassan II University Hospital Fez of Morocco: a research attempt

Abdioui

Ouddasser

Belyagou

et al. 2022

2022 14th International Colloquium of Logistics and Supply Chain Management (LOGISTIQUA)

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General Characteristics and Activity of Emergency Department Short-Stay Units in Spanish Hospitals

Cited by 5 publications

References 6 publications

Impact of emergency short‐stay unit opening on in‐hospital global and cardiology indicators

Impact of emergency short‐stay unit opening on in‐hospital global and cardiology indicators

Emergency department direct discharge compared to short-stay unit admission for selected patients with acute heart failure: analysis of short-term outcomes

Activity-based pricing and financial performance in Hassan II University Hospital Fez of Morocco: a research attempt

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