OBJECTIVE: To compare the effectiveness of interventions aimed at reducing the rate of acute paediatric hospital admissions. DESIGN: Systematic review. DATA SOURCES: Medline, Embase, PsychINFO, The Cochrane Library, Science Citation Index Expanded from inception to September 2010; hand searches of the reference lists of included papers and other review papers identified in the search. REVIEW METHODS: Controlled trials were included. Articles were screened for inclusion independently by two reviewers. Data extraction and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. RESULTS: Seven papers were included. There is some evidence to suggest that short stay units may reduce admission rates. However, there is a general lack of detail in the reporting of interventions and the methods used in their evaluation which precludes detailed interpretation and extrapolation of the results. The authors found no evidence that the use of algorithms and guidelines to manage the admission decision was effective in reducing acute admission rates. Furthermore, the authors were unable to locate any eligible papers reporting the effects on admission rates of admission decision by paediatric consultant, telephone triage by paediatric consultant or the establishment of next day emergency paediatric clinics. CONCLUSION: There is little published evidence upon which to base an optimal strategy for reducing paediatric admission rates. The evidence that does exist is subject to substantial bias. There is a pressing need for high quality, well conducted research to enable informed service change.
OBJECTIVE: To compare the effectiveness of interventions aimed at reducing the rate of acute paediatric hospital admissions. DESIGN: Systematic review. DATA SOURCES: Medline, Embase, PsychINFO, The Cochrane Library, Science Citation Index Expanded from inception to September 2010; hand searches of the reference lists of included papers and other review papers identified in the search. REVIEW METHODS: Controlled trials were included. Articles were screened for inclusion independently by two reviewers. Data extraction and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. RESULTS: Seven papers were included. There is some evidence to suggest that short stay units may reduce admission rates. However, there is a general lack of detail in the reporting of interventions and the methods used in their evaluation which precludes detailed interpretation and extrapolation of the results. The authors found no evidence that the use of algorithms and guidelines to manage the admission decision was effective in reducing acute admission rates. Furthermore, the authors were unable to locate any eligible papers reporting the effects on admission rates of admission decision by paediatric consultant, telephone triage by paediatric consultant or the establishment of next day emergency paediatric clinics. CONCLUSION: There is little published evidence upon which to base an optimal strategy for reducing paediatric admission rates. The evidence that does exist is subject to substantial bias. There is a pressing need for high quality, well conducted research to enable informed service change.
Authors: Mark L Everard; Daniel Hind; Kelechi Ugonna; Jennifer Freeman; Mike Bradburn; Cindy L Cooper; Elizabeth Cross; Chin Maguire; Hannah Cantrill; John Alexander; Paul S McNamara Journal: Thorax Date: 2014-12 Impact factor: 9.139
Authors: Katie Harron; Ruth Gilbert; David Cromwell; Sam Oddie; Astrid Guttmann; Jan van der Meulen Journal: BMJ Qual Saf Date: 2017-06-12 Impact factor: 7.035
Authors: Kerryn Husk; Vashti Berry; Richard Tozer; Gina Skipwith; Robert Radmore; Susan Ball; Obioha C Ukoumunne; Stuart Logan Journal: BMJ Paediatr Open Date: 2018-03-28
Authors: Niklas Bobrovitz; Carl Heneghan; Igho Onakpoya; Benjamin Fletcher; Dylan Collins; Alice Tompson; Joseph Lee; David Nunan; Rebecca Fisher; Brittney Scott; Jack O'Sullivan; Oliver Van Hecke; Brian D Nicholson; Sarah Stevens; Nia Roberts; Kamal R Mahtani Journal: BMC Med Date: 2018-07-26 Impact factor: 8.775