PMID- 20235288
OWN - NLM
STAT- MEDLINE
DCOM- 20100817
LR  - 20181201
IS  - 1553-5606 (Electronic)
IS  - 1553-5592 (Print)
IS  - 1553-5592 (Linking)
VI  - 5
IP  - 3
DP  - 2010 Mar
TI  - Pediatric observation units in the United States: a systematic review.
PG  - 172-82
LID - 10.1002/jhm.592 [doi]
AB  - BACKGROUND: As more efficient and value-based care models are sought for the US 
      healthcare system, geographically distinct observation units (OUs) may become an 
      integral part of hospital-based care for children. PURPOSE: To systematically 
      review the literature and evaluate the structure and function of pediatric OUs in 
      the United States. DATA SOURCES: Searches were conducted in Medline, Web of 
      Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), 
      Health Care Advisory Board (HCAB), Lexis-Nexis, National Guideline Clearinghouse, 
      and Cochrane Reviews, through February 2009, with review of select 
      bibliographies. STUDY SELECTION: English language peer-reviewed publications on 
      pediatric OU care in the United States. DATA EXTRACTION: Two authors 
      independently determined study eligibility. Studies were graded using a 5-level 
      quality assessment tool. Data were extracted using a standardized form. DATA 
      SYNTHESIS: A total of 21 studies met inclusion criteria: 2 randomized trials, 2 
      prospective observational, 12 retrospective cohort, 2 before and after, and 3 
      descriptive studies. Studies present data on more than 22,000 children cared for 
      in OUs, most at large academic centers. This systematic review provides a 
      descriptive overview of the structure and function of pediatric OUs in the United 
      States. Despite seemingly straightforward outcomes for OU care, significant 
      heterogeneity in the reporting of length of stay, admission rates, return visit 
      rates, and costs precluded our ability to conduct meta-analyses. We propose 
      standard outcome measures and future directions for pediatric OU research. 
      CONCLUSIONS: Future research using consistent outcome measures will be critical 
      to determining whether OUs can improve the quality and cost of providing care to 
      children requiring observation-length stays.
FAU - Macy, Michelle L
AU  - Macy ML
AD  - Division of General Pediatrics, Child Health Evaluation and Research Unit, 
      University of Michigan, Ann Arbor, Michigan 48109-5456, USA. mlmacy@umich.edu
FAU - Kim, Christopher S
AU  - Kim CS
FAU - Sasson, Comilla
AU  - Sasson C
FAU - Lozon, Marie M
AU  - Lozon MM
FAU - Davis, Matthew M
AU  - Davis MM
LA  - eng
GR  - T32 HD007534/HD/NICHD NIH HHS/United States
GR  - T32 HD007534-08/HD/NICHD NIH HHS/United States
GR  - T32 HD007534-09/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - J Hosp Med
JT  - Journal of hospital medicine
JID - 101271025
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Databases, Bibliographic
MH  - Hospital Units
MH  - *Hospitals, Pediatric
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Observation/*methods
MH  - Pediatrics/*methods
MH  - United States
PMC - PMC2860021
MID - NIHMS123843
EDAT- 2010/03/18 06:00
MHDA- 2010/08/18 06:00
PMCR- 2011/03/01
CRDT- 2010/03/18 06:00
PHST- 2010/03/18 06:00 [entrez]
PHST- 2010/03/18 06:00 [pubmed]
PHST- 2010/08/18 06:00 [medline]
PHST- 2011/03/01 00:00 [pmc-release]
AID - 10.1002/jhm.592 [doi]
PST - ppublish
SO  - J Hosp Med. 2010 Mar;5(3):172-82. doi: 10.1002/jhm.592.