التفاصيل البيبلوغرافية
| العنوان: |
Value-based comparison of ambulatory children with respiratory diseases in an emergency department and a walk-in clinic: a retrospective cohort study in Québec, Canada |
| المؤلفون: |
Marx, Tania, Moore, Lynne, Talbot, Denis, Guertin, Jason Robert, Lachapelle, Philippe, Blais, Sébastien, Singbo, Narcisse, Simonyan, David, Lavallée, Jeanne, Zada, Nawid, Shahrigharahkoshan, Shaghayegh, Huard, Benoit, Olivier, Pascale, Mallet, Myriam, Létourneau, Mélanie, Lafrenière, Michel, Archambault, Patrick, Berthelot, Simon |
| المساهمون: |
Fonds de Recherche du Québec - Santé |
| المصدر: |
BMJ Open ; volume 14, issue 4, page e078566 ; ISSN 2044-6055 2044-6055 |
| بيانات النشر: |
BMJ |
| سنة النشر: |
2024 |
| الوصف: |
Objective To compare health outcomes and costs given in the emergency department (ED) and walk-in clinics for ambulatory children presenting with acute respiratory diseases. Design A retrospective cohort study. Setting This study was conducted from April 2016 to March 2017 in one ED and one walk-in clinic. The ED is a paediatric tertiary care centre, and the clinic has access to lab tests and X-rays. Participants Inclusion criteria were children: (1) aged from 2 to 17 years old and (2) discharged home with a diagnosis of upper respiratory tract infection (URTI), pneumonia or acute asthma. Main outcome measures The primary outcome measure was the proportion of patients returning to any ED or clinic within 3 and 7 days of the index visit. The secondary outcome measures were the mean cost of care estimated using time-driven activity-based costing and the incidence of antibiotic prescription for URTI patients. Results We included 532 children seen in the ED and 201 seen in the walk-in clinic. The incidence of return visits at 3 and 7 days was 20.7% and 27.3% in the ED vs 6.5% and 11.4% in the clinic (adjusted relative risk at 3 days (aRR) (95% CI) 3.17 (1.77 to 5.66) and aRR at 7 days 2.24 (1.46 to 3.44)). The mean cost (95% CI) of care (CAD) at the index visit was $C96.68 (92.62 to 100.74) in the ED vs $C48.82 (45.47 to 52.16) in the clinic (mean difference (95% CI): 46.15 (41.29 to 51.02)). Antibiotic prescription for URTI was less common in the ED than in the clinic (1.5% vs 16.4%; aRR 0.10 (95% CI 0.03 to 0.32)). Conclusions The incidence of return visits and cost of care were significantly higher in the ED, while antibiotic use for URTI was more frequent in the walk-in clinic. These data may help determine which setting offers the highest value to ambulatory children with acute respiratory conditions. |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1136/bmjopen-2023-078566 |
| الإتاحة: |
https://doi.org/10.1136/bmjopen-2023-078566Test |
| حقوق: |
http://creativecommons.org/licenses/by-nc/4.0Test/ |
| رقم الانضمام: |
edsbas.AD53198A |
| قاعدة البيانات: |
BASE |
