Browne G J, Penna A
Children's Emergency Department, Westmead Hospital, Sydney, Australia.
Arch Dis Child. 1996 Apr;74(4):309-13. doi: 10.1136/adc.74.4.309.
Many children admitted to hospital can stay for 24 hours or less. Short stay facilities offer such children rapid stabilisation and early discharge with considerable financial saving. A 12 month study was completed in which data were collected from the children's emergency annex (CEA) at Westmead Hospital in Sydney's western suburbs. This university based teaching hospital provides care for a large paediatric population as well as three other district hospitals with limited children's bed capacity. From April 1994 to April 1995, 1300 children were admitted and entered into a database of general and hospital-specific information. Critical incident monitoring was undertaken and follow up with review within 24-72 hours for all children. The CEA increased hospital efficiency significantly by reducing bed days, with a saving of over $500,000 to the department. The average length of stay was 17.5 hours, and 58% of users were children of 2 years and under. Only 3% remained beyond 24 hours, and another 4% were admitted to inpatient beds for continued management of the primarily diagnosed condition. No critical incident was reported during this 12 month period. Short stay facilities are efficient and cost-effective for children with acute illness who can be rapidly stabilised with early discharge without critical incident. Children 12 months and under are particularly suited to this type of facility. Short stay facilities should be used to augment efficiency within children's emergency services which have high turnover and limited bed capacity.
许多住院的儿童住院时间可在24小时或更短。短期住院设施为这类儿童提供快速病情稳定和早期出院服务，同时节省大量资金。一项为期12个月的研究完成了，在此期间收集了悉尼西郊韦斯特米德医院儿童急诊附属楼（CEA）的数据。这家大学教学医院为大量儿科患者提供护理服务，同时也为另外三家儿童床位有限的地区医院提供服务。从1994年4月到1995年4月，1300名儿童入院并录入了一个包含一般信息和医院特定信息的数据库。对所有儿童进行了危急事件监测，并在24至72小时内进行随访复查。CEA通过减少住院天数显著提高了医院效率，为该科室节省了超过50万美元。平均住院时间为17.5小时，58%的使用者为2岁及以下儿童。只有3%的儿童住院时间超过24小时，另外4%的儿童被转入住院病床，以便对主要诊断疾病进行持续治疗。在这12个月期间未报告任何危急事件。对于能够快速病情稳定并早期出院且无危急事件的急性病儿童，短期住院设施高效且具有成本效益。12个月及以下的儿童尤其适合这类设施。短期住院设施应被用于提高儿童急诊服务的效率，因为儿童急诊服务周转率高且床位有限。
