TY - JOUR
T1 - Evolving treatment in a decade of pediatric burn care
AU - Foglia, Robert P.
AU - Moushey, Robin
AU - Meadows, Lisa
AU - Seigel, Jennifer
AU - Smith, Maureen
PY - 2004/6
Y1 - 2004/6
N2 - Backround Over the last decade, an ambulatory burn care (ABC) and procedural sedation (PS) program was instituted at St Louis Children's Hospital (SLCH). This study assessed the effect of these interventions on resource utilization. Methods The authors reviewed the hospital experience comparing 1993 with 2002 data regarding gender, age, burn depth, patient admissions, inpatient days, and ABC visits. Outcome measures included length of stay (LOS), incidence of infection, and hospital charges. Results Gender, age, and burn depth were similar; 192 patients were admitted in 1993. In 2002, there were 167 admissions and 118 patients treated solely on an ABC basis resulting in a total of 285 burn patients treated (+48%). Hospital days decreased from 2,041 (1993) to 963 (2002 [-53%]). LOS declined from 10.4 ± 8.3 days (1993) to 5.8 ± 14.2 days (2002 [-44%; P < .05]). PS was used sporadically in 1993, and increased to 71% in patients in 2002. There were no ABC visits in 1993 and 501 visits in 2002. The incidence of infection was 5.2% in 1993 versus 3.0% in 2002 (P < .05) Average charge per patient fell 45% from $13,286 (1993) to $7,372 (2002), adjusted to 1993 dollars using medical care price index. Conclusions Over a 10-year period, the program achieved a significant reduction in resource utilization while increasing the number of patients treated and maintaining a low incidence of infection. This was due in large part to a shift to ABC and the use of PS.
AB - Backround Over the last decade, an ambulatory burn care (ABC) and procedural sedation (PS) program was instituted at St Louis Children's Hospital (SLCH). This study assessed the effect of these interventions on resource utilization. Methods The authors reviewed the hospital experience comparing 1993 with 2002 data regarding gender, age, burn depth, patient admissions, inpatient days, and ABC visits. Outcome measures included length of stay (LOS), incidence of infection, and hospital charges. Results Gender, age, and burn depth were similar; 192 patients were admitted in 1993. In 2002, there were 167 admissions and 118 patients treated solely on an ABC basis resulting in a total of 285 burn patients treated (+48%). Hospital days decreased from 2,041 (1993) to 963 (2002 [-53%]). LOS declined from 10.4 ± 8.3 days (1993) to 5.8 ± 14.2 days (2002 [-44%; P < .05]). PS was used sporadically in 1993, and increased to 71% in patients in 2002. There were no ABC visits in 1993 and 501 visits in 2002. The incidence of infection was 5.2% in 1993 versus 3.0% in 2002 (P < .05) Average charge per patient fell 45% from $13,286 (1993) to $7,372 (2002), adjusted to 1993 dollars using medical care price index. Conclusions Over a 10-year period, the program achieved a significant reduction in resource utilization while increasing the number of patients treated and maintaining a low incidence of infection. This was due in large part to a shift to ABC and the use of PS.
KW - Burns
KW - ambulatory care
KW - resource utilization
UR - http://www.scopus.com/inward/record.url?scp=3042672588&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=3042672588&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2004.04.001
DO - 10.1016/j.jpedsurg.2004.04.001
M3 - Article
C2 - 15185233
AN - SCOPUS:3042672588
SN - 0022-3468
VL - 39
SP - 957
EP - 960
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 6
ER -