Evaluation of a pediatric emergency observation unit:an analysis of 5471 observation pediatric patients

Abstract

Objective To evaluatethefunctions of an emergency pediatric observation unit(OU).Method The OU located in the Second Affdiated Hospital ＆Yuying Children'Hospital of Wenzhou Medical CoHege.a pediatric tertiary care teaching hospital.The records of all patients admitted to OU and the discharge diagnoses of all patients ofinpatient unit(IU)from January to December 2006 were retrospectively analyzed.[)d(Is ratios(OR) witll 95%C1 was used to show the advantages ofOU in SOme pedian4c diSOrders.Results There were45 beds in the OU,and 348 beds in tlle IU.111e number ofthe patients in OU per year WaS 42.5%compared to IU f5471 Vs.12 881).The average number of patients in OU per bed in one year WaS 122.which was 3 times as much as the average number of patients in IU admission per bed(122 vs.37).Totally 3879(70.9%)patients in OU were discharged and 1592(29.1%)were transferred.For the olmervation patie.ts,the IIIeaIl age Was 7 years old.with 65.6%under or equal to 2 years old.The 111ean le,ch of stay(IDS)in OU was95.7 hours.Respiratory disorders(2204/5471,40.3%)and gastrointestinal problems(960/5471,17.5%)were the most common disease in OU.Of the total admission(IU and ou),diagnoses with high OU utilization were croup(73/75,97.3%),poiflonin(277/,97.2%),flsthma(128/133,96.2%),fleiZl.1lwith high fever(274/365,75.1%),enteritis/dehydration(618/726,85.1%),seizure with 110 fever(274/365,75.1%)and acute respiratory infection(486/624.77.9%).The likelihood of an OU admifor these illness vells IU addlission(adjusted for subsequent need for IU admission)was poisonings OR 43.21(26.1,71.6),P<0.001;croup 15.7(8.3,29.7),P<0.001:asthma 0R 10.5(7.0,15.8),P<0.001;seizure with high fever OR 8.5(6.5,11.1),P<0.001;seizure with no fever2.6(2.2,3.1),P<0.001;acute respiratory infection 0R 1.0(0.9,1.1),P=O.591;enteritis/dehydration 1.0(0.9 1.1),P=0.919.Conclusions The emergency OU,characterized by large ac.commodation,fast circulation and high utilization rate of bed,plays an important role in observation,treatment and hospital admission of children,esoeeially infants and young children for common pediatric diseases.The emergency observation unit is also an alternative disposition for certain pediatric diseases.The extending construefion of OU in a childrenS hospital with big population of out-/in-patients is an effective way to the hospital resources. Key words: Pediatric emergency OU; Function evaluation; Retrospective cohort review; Sepectnan ofdisease