دورية أكاديمية
Impact of Deferring Critically Ill Children Away from Their Designated Pediatric Critical Care Unit: A Population-Based Retrospective Cohort Study.
| العنوان: | Impact of Deferring Critically Ill Children Away from Their Designated Pediatric Critical Care Unit: A Population-Based Retrospective Cohort Study. |
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| المؤلفون: | Tijssen JA; Children's Hospital, London Health Sciences Centre, Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON., Allen BN; Institute of Clinical Evaluative Sciences, Western Site (ICES Western), London, ON., Jenkyn KMB; Institute of Clinical Evaluative Sciences, Western Site (ICES Western), London, ON., Shariff SZ; Institute of Clinical Evaluative Sciences, Western Site (ICES Western), Arthur Labatt School of Nursing, Western University, London, ON. |
| المصدر: | Healthcare policy = Politiques de sante [Healthc Policy] 2019 Aug; Vol. 15 (1), pp. 40-52. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Longwoods Pub Country of Publication: Canada NLM ID: 101280107 Publication Model: Print Cited Medium: Internet ISSN: 1715-6580 (Electronic) Linking ISSN: 17156572 NLM ISO Abbreviation: Healthc Policy Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Toronto, Ont. : Longwoods Pub., 2005- |
| مواضيع طبية MeSH: | Critical Care/*organization & administration , Critical Illness/*therapy , Intensive Care Units, Pediatric/*organization & administration , Patient Transfer/*organization & administration , Referral and Consultation/*organization & administration , Regional Medical Programs/*organization & administration , Transportation of Patients/*organization & administration, Adolescent ; Child ; Child, Preschool ; Cohort Studies ; Critical Care/statistics & numerical data ; Critical Care/trends ; Female ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric/statistics & numerical data ; Male ; Ontario ; Patient Transfer/statistics & numerical data ; Population Surveillance ; Referral and Consultation/statistics & numerical data ; Regional Medical Programs/statistics & numerical data ; Retrospective Studies ; Transportation of Patients/statistics & numerical data |
| مستخلص: | Background: The impact of deferring critically ill children in referral hospitals away from their designated pediatric critical care unit (PCCU) on patients and the healthcare system is unknown. We aimed to identify factors associated with deferrals and patient outcomes and to study the impact of a referral policy implemented to balance PCCU bed capacity with regional needs. Methods: We conducted a population-based retrospective cohort study of admissions to a PCCU following inter-facility transport from 2004 to 2016 in Ontario, Canada. Results: Of 10,639 inter-facility transfers, 24.8% (95% confidence interval [CI]: 23.5-26.1%) were deferred during pre-implementation and 16.0% (95% CI: 15.1-16.9%) during post-implementation of a referral policy. Several factors, including previous intensive care unit admissions, residence location, presenting hospital factors, patient co-morbidities, specific designated PCCUs and winter (versus summer) season, were associated with deferral status. Deferrals were not associated with increased mortality. Conclusions: Deferral from a designated PCCU does not confer an increased risk of death. Implementation of a referral policy was associated with a consistent referral pattern in 84% of transfers. (Copyright © 2019 Longwoods Publishing.) |
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| تواريخ الأحداث: | Date Created: 20191021 Date Completed: 20200907 Latest Revision: 20240328 |
| رمز التحديث: | 20240329 |
| مُعرف محوري في PubMed: | PMC7008691 |
| DOI: | 10.12927/hcpol.2019.25939 |
| PMID: | 31629455 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1715-6580 |
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| DOI: | 10.12927/hcpol.2019.25939 |