Effectiveness of multifunction paediatric short-stay units: a French multicentre study
Version of Record online: 11 JUN 2011
© 2011 The Author(s)/Acta Pædiatrica © 2011 Foundation Acta Pædiatrica
Volume 100, Issue 11, pages e227–e233, November 2011
How to Cite
Najaf-Zadeh, A., Hue, V., Bonnel-Mortuaire, C., Dubos, F., Pruvost, I., the GFRUP study group and Martinot, A. (2011), Effectiveness of multifunction paediatric short-stay units: a French multicentre study. Acta Paediatrica, 100: e227–e233. doi: 10.1111/j.1651-2227.2011.02356.x
- Issue online: 10 OCT 2011
- Version of Record online: 11 JUN 2011
- Accepted manuscript online: 16 MAY 2011 02:24PM EST
- Received 21 January 2011; revised 21 March 2011; accepted 11 May 2011.
- Emergency department;
- Emergency medicine;
- Observation unit;
Aim: To describe the characteristics of the activities of multifunction paediatric ‘short-stay units’ (SSU) including observation unit (OU), medical assessment and planning unit (MAPU) and holding unit (HU), to evaluate their effectiveness and to explore predictors of inappropriate admissions for OU patients.
Methods: Admissions to nine French paediatric SSUs were analysed. The main outcome measures were SSU length of stay with associated outcome for all patients and appropriate admission rate for OU patients.
Results: Of 1084 patients included in the study, 66% were OU patients (n = 718), 21% MAPU patients (n = 225) and 13% HU patients (n = 141). The OU patients constituted the majority of the SSU admissions. The appropriate OU admission rates ranged from 52% to 86%. Head trauma and seizure were the conditions with the highest appropriate OU admission rates (82%). Age <1 year, and need for IV fluids or medications, CT-Scan or MRI and cardiorespiratory monitoring were associated with an increased risk of inappropriate OU admission. Eighteen per cent of the MAPU patients and 5% of the HU patients were discharged home within 24 h.
Conclusion: By providing extended and easily available facilities for diagnostics and early treatment for a wide range of sick children, the French paediatric SSU is an effective model for ‘observation medicine’ in emergency department-managed units. The experience and principles may be applicable to similar units in other health care systems.