title: Effectiveness of multifunction paediatric short-stay units: a French multicentre study.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Univ Lille Nord de France, UDSL, France.
authors.forename: A
authors.initials: A
authors.lastname: Najaf-Zadeh
authors.forename: V
authors.initials: V
authors.lastname: Hue
authors.forename: C
authors.initials: C
authors.lastname: Bonnel-Mortuaire
authors.forename: F
authors.initials: F
authors.lastname: Dubos
authors.forename: I
authors.initials: I
authors.lastname: Pruvost
authors.forename: A
authors.initials: A
authors.lastname: Martinot
mesh_terms: D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D005602:France; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D019370:Observation; D010343:Patient Admission / Q000592:standards* / Q000706:statistics & numerical data; D010372:Pediatrics / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D015397:Program Evaluation; D011446:Prospective Studies