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Patient and economic impact of implementing a paediatric sepsis pathway in emergency departments in Queensland, Australia.
Blythe, Robin; Lister, Paula; Seaton, Robert; Harley, Amanda; Schlapbach, Luregn J; McPhail, Steven; Venkatesh, Bala; Irwin, Adam; Raman, Sainath.
Afiliación
  • Blythe R; Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, QLD, 4059, Australia. Robin.blythe@qut.edu.au.
  • Lister P; Queensland Paediatric Sepsis Program, Children's Health and Youth Network, Children's Health Queensland, Brisbane, Australia.
  • Seaton R; Paediatric Intensive Care Unit, Sunshine Coast University Hospital, Birtinya, Australia.
  • Harley A; Department of Health, Clinical Excellence Queensland, Brisbane, QLD, Australia.
  • Schlapbach LJ; Queensland Paediatric Sepsis Program, Children's Health and Youth Network, Children's Health Queensland, Brisbane, Australia.
  • McPhail S; Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia.
  • Venkatesh B; Critical Care Nursing Management Team, Queensland Children's Hospital, Brisbane, QLD, Australia.
  • Irwin A; School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, QLD, Australia.
  • Raman S; Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia.
Sci Rep ; 12(1): 10113, 2022 06 16.
Article en En | MEDLINE | ID: mdl-35710798
We examined systems-level costs before and after the implementation of an emergency department paediatric sepsis screening, recognition and treatment pathway. Aggregated hospital admissions for all children aged < 18y with a diagnosis code of sepsis upon admission in Queensland, Australia were compared for 16 participating and 32 non-participating hospitals before and after pathway implementation. Monte Carlo simulation was used to generate uncertainty intervals. Policy impacts were estimated using difference-in-difference analysis comparing observed and expected results. We compared 1055 patient episodes before (77.6% in-pathway) and 1504 after (80.5% in-pathway) implementation. Reductions were likely for non-intensive length of stay (- 20.8 h [- 36.1, - 8.0]) but not intensive care (-9.4 h [- 24.4, 5.0]). Non-pathway utilisation was likely unchanged for interhospital transfers (+ 3.2% [- 5.0%, 11.4%]), non-intensive (- 4.5 h [- 19.0, 9.8]) and intensive (+ 7.7 h, [- 20.9, 37.7]) care length of stay. After difference-in-difference adjustment, estimated savings were 596 [277, 942] non-intensive and 172 [148, 222] intensive care days. The program was cost-saving in 63.4% of simulations, with a mean value of $97,019 [- $857,273, $1,654,925] over 24 months. A paediatric sepsis pathway in Queensland emergency departments was associated with potential reductions in hospital utilisation and costs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sepsis / Servicio de Urgencia en Hospital Tipo de estudio: Diagnostic_studies / Health_economic_evaluation Límite: Child / Humans País/Región como asunto: Oceania Idioma: En Revista: Sci Rep Año: 2022 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sepsis / Servicio de Urgencia en Hospital Tipo de estudio: Diagnostic_studies / Health_economic_evaluation Límite: Child / Humans País/Región como asunto: Oceania Idioma: En Revista: Sci Rep Año: 2022 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido