Impact of a Short Stay Unit on Asthma Patients Admitted to a Tertiary Pediatric Hospital

Marks, MK; Lovejoy, Frederick H.; Rutherford, Patricia; Baskin, Marc N.

doi:10.1097/00019514-199706010-00002

Cited by 22 publications

(36 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…24 Similar to prior studies, 4,15,[25][26][27][28][29][30] our results also indicate that return visits and readmissions following observation are uncommon events. Our findings can serve as initial benchmarks for condition-specific outcomes for pediatric observation care.…”

Section: Discussionsupporting

confidence: 85%

“…Although the duration of observation is often less than 24 hours, hospitals may allow a patient to remain under observation for longer durations. 15,16 Duration of stay is not defined precisely enough within PHIS to determine hours of inpatient care. Therefore, length of stay (LOS) was not used to determine observation status stays.…”

Section: Variable Definitionsmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric observation status: Are we overlooking a growing population in children's hospitals?

Macy

Hall

Shah

et al. 2012

Journal of Hospital Medicine

View full text Add to dashboard Cite

BACKGROUND: Inpatient administrative datasets often exclude observation stays, as observation is considered to be outpatient care. The extent to which this status is applied to pediatric hospitalizations is not known. OBJECTIVE: To characterize trends in observation status code utilization and 1‐day stays among children admitted from the emergency department (ED), and to compare patient characteristics and outcomes associated with observation versus inpatient stays. DESIGN: Retrospective longitudinal analysis of the 2004–2009 Pediatric Health Information System (PHIS). SETTING: Sixteen US freestanding children's hospitals contributing outpatient and inpatient data to PHIS. PATIENTS: Admissions to observation or inpatient status following ED care in study hospitals. MEASUREMENTS: Proportions of observation and 1‐day stays among all admissions from the ED were calculated each year. Top ranking discharge diagnoses and outcomes of observation were determined. Patient characteristics, discharge diagnoses, and return visits were compared for observation and 1‐day stays. RESULTS: The proportion of short‐stays (including both observation and 1‐day stays) increased from 37% to 41% between 2004 and 2009. Since 2007, observation stays have outnumbered 1‐day stays. In 2009, more than half of admissions from the ED for 6 of the top 10 ranking discharge diagnoses were short‐stays. Fewer than 25% of observation stays converted to inpatient status. Return visits and readmissions following observation were no more frequent than following 1‐day stays. CONCLUSIONS: Children admitted under observation status make up a substantial proportion of acute care hospitalizations. Analyses of inpatient administrative databases that exclude observation stays likely result in an underestimation of hospital resource utilization for children. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Variable Definitionsmentioning

confidence: 99%

Pediatric observation status: Are we overlooking a growing population in children's hospitals?

Macy

Hall

Shah

et al. 2012

Journal of Hospital Medicine

View full text Add to dashboard Cite

show abstract

“…3 A handful of centers have reported on their positive experiences with geographically distinct pediatric OU, suggesting benefits including decreased admissions to inpatient units, [4][5][6][7][8] shorter lengths of stay (LOS), 4,7,9,10 and lower costs of care. 4,7,10,11 Although numbers of pediatric OU are not tracked, 3 a recent survey indicates that few children's hospitals have dedicated OU. 12 Pediatric EDs in institutions without OU may choose to provide observation care within the ED itself, ie, ED virtual observation, but descriptions of this model of care are lacking.…”

Section: Conclusion: Admission Rates For Observation-eligible Visitsmentioning

confidence: 99%

Effect of Using Pediatric Emergency Department Virtual Observation on Inpatient Admissions and Lengths of Stay

Cator

Weber

Lozon

et al. 2014

Academic Pediatrics

View full text Add to dashboard Cite

“…13 There are single-site examples of observation care delivered in other settings. 14,15 In 2 national surveys of US General Hospitals, 25% provided observation services in beds adjacent to the ED, and the remainder provided observation services in hospital inpatient units. 16,17 However, we are not aware of any previous multi-institution studies exploring hospitalwide practices related to observation care for children.…”

mentioning

confidence: 99%

Differences in designations of observation care in US freestanding children's hospitals: Are they virtual or real?

Macy¹,

Hall²,

Shah³

et al. 2011

Journal of Hospital Medicine

View full text Add to dashboard Cite

OBJECTIVE:To characterize practices related to observation care and to examine the current models of pediatric observation medicine in US children's hospitals.DESIGN:We utilized 2 web‐based surveys to examine observation care in the 42 hospitals participating in the Pediatric Health Information System database. We obtained information regarding the designation of observation status, including the criteria used to admit patients into observation. From hospitals reporting the use of observation status, we requested specific details relating to the structures of observation care and the processes of care for observation patients following emergency department treatment.RESULTS:A total of 37 hospitals responded to Survey 1, and 20 hospitals responded to Survey 2. Designated observation units were present in only 12 of 31 (39%) hospitals that report observation patient data to the Pediatric Health Information System. Observation status was variably defined in terms of duration of treatment and prespecified criteria. Observation periods were limited to <48 hours in 24 of 31 (77%) hospitals. Hospitals reported that various standards were used by different payers to determine observation status reimbursement. Observation care was delivered in a variety of settings. Most hospitals indicated that there were no differences in the clinical care delivered to virtual observation status patients when compared with other inpatients.CONCLUSIONS:Observation is a variably applied patient status, defined differently by individual hospitals. Consistency in the designation of patients under observation status among hospitals and payers may be necessary to compare quality outcomes and costs, as well as optimize models of pediatric observation care.Journal of Hospital Medicine 2012;. © 2011 Society of Hospital Medicine.

show abstract

Impact of a Short Stay Unit on Asthma Patients Admitted to a Tertiary Pediatric Hospital

Cited by 22 publications

References 0 publications

Pediatric observation status: Are we overlooking a growing population in children's hospitals?

Pediatric observation status: Are we overlooking a growing population in children's hospitals?

Effect of Using Pediatric Emergency Department Virtual Observation on Inpatient Admissions and Lengths of Stay

Differences in designations of observation care in US freestanding children's hospitals: Are they virtual or real?

Contact Info

Product

Resources

About