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Impact of emergency short-stay unit opening on in-hospital global and cardiology indicators.
Cirillo, Willian; Freitas, Lidia R C; Kitaka, Edson L; Matos-Souza, José R; Silva, Marcos R; Coelho, Otávio R; Coelho-Filho, Otávio R; Sposito, Andrei C; Nadruz, Wilson.
Afiliação
  • Cirillo W; Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil.
  • Freitas LRC; Division of Informatics, Clinics Hospital, State University of Campinas, Campinas, Brazil.
  • Kitaka EL; Division of Informatics, Clinics Hospital, State University of Campinas, Campinas, Brazil.
  • Matos-Souza JR; Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil.
  • Silva MR; Emergency Division, Clinics Hospital, State University of Campinas, Campinas, Brazil.
  • Coelho OR; Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil.
  • Coelho-Filho OR; Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil.
  • Sposito AC; Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil.
  • Nadruz W; Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil.
J Eval Clin Pract ; 27(6): 1262-1270, 2021 12.
Article em En | MEDLINE | ID: mdl-33421284
RATIONALE, AIMS AND OBJECTIVES: Emergency short-stay unit (SSU) alleviates emergency department (ED) overcrowding, but may affect in-hospital indicators. Cardiology patients comprise a substantial part of patients admitted at SSU. This study evaluated whether SSU opening differentially modified in-hospital indicators at a whole general hospital and at its cardiology division (CARD). METHODS: We retrospectively analysed indicators based on 859 686 ED visits, and 171 547 hospital admissions, including 12 110 CARD admissions, from 2007 to 2018 at a general tertiary hospital, and compared global ED indicators and in-hospital indicators at the hospital and CARD before (2007-2011) and after (2011-2018) SSU opening. RESULTS: After SSU opening, monthly ED bed occupancy rate decreased (mean ± SD 200 ± 18% vs 187 ± 22%; P < .001) and in-hospital admissions from ED increased at the hospital (median [interquartile range] 460 [81] vs 524 [41], P < .001) and CARD (50 [12] vs 54 [12], P = .004). In parallel, monthly in-hospital elective admissions decreased at CARD (34 [18] vs 28 [17], P = .019), but not at the hospital (712 [73] vs 700 [104], P = .54). Average length of stay (LOS) increased at both hospital (8.5 ± 0.3 vs 8.7 ± 0.4 days, P < .001) and CARD (9.2 ± 1.5 vs 10.3 ± 2.3 days, P = .002) after SSU opening, but percent admissions at SSU showed a direct relationship with LOS solely at CARD. Furthermore, cardiology patients admitted at SSU had greater LOS, prevalence of coronary heart disease and age than those admitted at the conventional cardiology ward. CONCLUSIONS: SSU opening improved ED crowding, but was associated with changes in in-hospital indicators, particularly at CARD, and in the characteristics of hospitalized cardiology patients. These findings suggest that in-hospital cardiology services may need re-evaluation following SSU opening at a general hospital.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cardiologia / Serviço Hospitalar de Emergência Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Eval Clin Pract Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cardiologia / Serviço Hospitalar de Emergência Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Eval Clin Pract Assunto da revista: PESQUISA EM SERVICOS DE SAUDE Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido