Abstract:
:This study sought to determine if a clinical pathway developed and executed by specialists in pediatric asthma would reduce hospital costs and length of stay (LOS). The study design was a retrospective, nonrandomized, controlled trial. Subjects were children aged 2-18 years (N = 1,004) with a history of recurrent wheezing, hospitalized with a diagnosis of acute asthma exacerbation between 1995-1998 at the New York Hospital-Weill Cornell Medical Center and treated via the pathway, as well as a control group of 206 children ages 2-18 hospitalized for acute asthma exacerbation in 1994, the year prior to pathway implementation. Patients were treated via the pathway under the supervision of an asthma specialist. The pathway provided guidelines for: 1) frequency of patient assessment; 2) bronchodilator usage; 3) corticosteroid use; 4) laboratory evaluation; 5) vital signs, oxygen saturation, and peak flow measurements; 6) chest x-rays; 7) social work intervention; and 8) discharge planning. The main outcome measures were hospital length of stay, cost per hospitalization, nursing, medication, laboratory and radiology costs, and relapse rate. Total charges for admission and average LOS for 1995-1998 were calculated, and compared with 1994, the year preceding implementation of the pathway. LOS decreased from 4.2 days to 2.7 days (P < 0.0001). The annual total charges for pediatric asthma admissions decreased from 2 million dollars to 1.4 million dollars (P < 0.005). Nursing and laboratory costs showed a statistically significant decrease. Follow-up study at 8 months showed a readmission rate of 0.02%. The implementation of a pediatric asthma clinical pathway, directed by specialists, resulted in significantly decreased length of stay and overall cost, without an increased rate of readmission.
journal_name
Pediatr Pulmonoljournal_title
Pediatric pulmonologyauthors
Wazeka A,Valacer DJ,Cooper M,Caplan DW,DiMaio Mdoi
10.1002/ppul.1110subject
Has Abstractpub_date
2001-09-01 00:00:00pages
211-6issue
3eissn
8755-6863issn
1099-0496pii
10.1002/ppul.1110journal_volume
32pub_type
杂志文章abstract::The purpose of the present study was to identify prognostic factors related to death in patients with cystic fibrosis (CF). Records of 127 patients with CF submitted to a systematic protocol were retrospectively reviewed. Prognostic factors associated with demographic, nutritional, clinical, and laboratory findings on...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.10149
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abstract:OBJECTIVES:In hospitalized and nonhospitalized children with asthma exacerbations, we evaluated the determinants of (a) prolonged cough on day-14 and (b) asthma quality of life (QoL) questionnaires for parents (PACQLQ) on day-21. We hypothesized that children with more severe acute asthma are more likely to have prolon...
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更新日期:2020-11-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章,随机对照试验
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.20512
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journal_title:Pediatric pulmonology
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更新日期:2009-07-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2002-02-01 00:00:00
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更新日期:2020-05-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
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更新日期:2007-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:1992-11-01 00:00:00
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更新日期:2019-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2002-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
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