期刊
PEDIATRICS
卷 121, 期 4, 页码 E906-E911出版社
AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2007-2089
关键词
hospitalized children; patient transfer; severity of illness; efficiency; outcome assessment; critical illness
类别
OBJECTIVE. The purpose of this work was to compare the outcomes, severity of illness, and resource use of patients transferred to PICUs from outside hospitals to patients admitted from within the same hospital. METHODS. We conducted a secondary analysis of patients from the 20 US PICUs in the most recent Pediatric Intensive Care Unit Evaluations Software Recalibration Database on a total of 13 017 emergent PICU admissions between January 2001 and January 2006. Dependent variables were PICU resource use and risk-adjusted mortality. The main independent variable was the PICU admission source: patients transferred from referring emergency departments and inpatient wards versus in-house admissions from the same hospitals' emergency departments and inpatient ward. RESULTS. Patients admitted from referring emergency departments had higher use of vasoactive infusions (7.31% vs 5.23%) and mechanical ventilation (33.45% vs 23.6%) than same-hospital emergency department admissions. Compared with inhouse ward admissions, patients transferred from referring inpatient wards had higher mechanical ventilation rates (45.05% vs 28.56%) and PICU lengths of stay (8.0 vs 6.7 days). CONCLUSIONS. On average, children admitted to a cohort of US PICUs from referring hospitals were more ill and required more intensive care resources than patients admitted to the same PICUs from within the institution. Hospital-level differences in PICU efficiency and severity of illness were highly variable. These data highlight the need for standardized PICU admission criteria to maximize hospital efficiency and suggest opportunities for earlier intervention and consultation by hospitals with PICU-level services to improve quality of care for critically ill children.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据