title: Effect of a pediatric observation unit on the rate of hospitalization for asthma.
abstract: OBJECTIVE
  To determine the asthma admission rate and the rate of repeat visits to the emergency department for asthma within 72 hours before and after the introduction of an observation unit (OU). When necessary, admission to the ward from the OU is usually made within 12 hours.
  
  
  METHODS
  We conducted a before-and-after study with retrospective data collection in an urban tertiary care pediatric ED. Our subjects were patients aged 1 to 18 years who presented to the ED with asthma. The pre-OU group comprised patients seen between July 1, 1991, and June 30, 1992, before the opening of the OU. The post-OU group consisted of children seen between July 1, 1993, and June 30, 1994, after the opening of the OU.
  
  
  RESULTS
  The pre- and post-OU groups had 1,979 and 2,248 asthma visits, respectively. The admission rate decreased from 31% in the pre-OU group to 24% in the post-OU group (P < .01). The frequency of inpatient admissions of less than 24 hours decreased from 17% in the pre-OU group to 10% in the post-OU group (P < or = 01). The rate of repeat ED visits within 72 hours was 3% in the pre-OU group and 5% in the post-OU group (P = .01).
  
  
  CONCLUSIONS
  The use of an OU in the ED was associated with a reduction in the hospitalization rate for children with acute asthma exacerbation. However, we also noted an increased rate of repeat visits to the ED after the introduction of the OU.
authors.affiliation: Division of Emergency Medicine, Hospital for Sick Children, University of Toronto, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Gouin
authors.forename: C
authors.initials: C
authors.lastname: Macarthur
authors.forename: P C
authors.initials: PC
authors.lastname: Parkin
authors.forename: S
authors.initials: S
authors.lastname: Schuh
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D012008:Recurrence; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D013256:Steroids