Abstract
BackgroundWhen medical wards become saturated, the common practice is to resort to outlying patients in another ward until a bed becomes free.ObjectivesCompare the quality of care provided for inpatients who are outlying (O) in inappropriate wards because of lack of vacant beds in appropriate specialty wards to the care given to non outlying (NO) patients.MethodsWe propose a matched-pair cluster study. The exposed group consisted of inpatients that were outliers in inappropriate wards because of lack of available beds. Non-exposed subjects (the control group) were those patients who were hospitalized in the ward that corresponded to the reason for their admission. Each patient of the exposed group was matched to a specific control subject. The principal objective was to prospectively measure differences in the length of hospital stays, the secondary objectives were to assess mortality, rate of re-admission at 28 days, and rate of transfer into intensive care.Results238 were included in the NO group, 245 in the O group. More patients in the O group (86% vs 76%) were transferred into a ward with prescription completed. O patients remained in hospital for 8 days [4-15] vs 7 days [4-13] for NO patients (p = 0.04). 124 (52%) of the NO patients received heparin-based thromboembolic prevention during their stay in hospital vs 104 (42%) of the O patient group (p = 0.03). 66 (27%) O patients were re-admitted to hospital within 28 days vs 40 (17%) NO patients (p = 0.008).ConclusionO patients had a worse prognosis than NO patients.
Highlights
French hospitals and their emergency departments (ED) are becoming more and more saturated
When particular wards are saturated, the common practice is to resort to outlying patients in another ward until a bed becomes free in the adequate ward [15]
Baseline characteristics 552 patients were initially included, of which 69 were untraceable. 238 patients were included in the non outlying group, 245 patients were included in the outlying group (Figure 1)
Summary
French hospitals and their emergency departments (ED) are becoming more and more saturated. The lack of beds downstream brings about longer boarding times in the ED before hospital admission. This has been described in a number of countries, When particular wards are saturated, the common practice is to resort to outlying patients in another ward until a bed becomes free in the adequate ward [15]. The outlying patients receive medical care from one ward but remain under the responsibility of doctors in the appropriate wards. Such temporary outlying may sometimes extend to the whole period of hospitalization. When medical wards become saturated, the common practice is to resort to outlying patients in another ward until a bed becomes free
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
