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Ambulatory paediatrics: does it work?
Insights
A new paediatric ambulatory assessment service significantly reduced hospital admissions by 47% within three years. Both general practitioners and parents reported high satisfaction, deeming the service effective and beneficial for children.
Area of Science:
- Pediatric Healthcare
- Health Services Research
- Ambulatory Care
Background:
- Inpatient pediatric units face challenges in managing patient flow and resource allocation.
- The need for efficient and effective pediatric assessment services is crucial for timely diagnosis and treatment.
- Evaluating alternative models of care, such as ambulatory services, is essential for optimizing pediatric healthcare delivery.
Purpose of the Study:
- To assess the effectiveness of a paediatric ambulatory assessment service as a substitute for inpatient care.
- To evaluate the acceptability and satisfaction levels of general practitioners and parents with the ambulatory service.
- To quantify the impact of the ambulatory service on paediatric hospital admission rates.
Main Methods:
- Analysis of paediatric medical hospital admissions before and after the service implementation.
- Postal questionnaire survey distributed to local general practitioners.
- Telephone survey conducted with parents of children utilizing the ambulatory assessment service.
Main Results:
- A 47% reduction in paediatric hospital admissions was observed by the third year of the ambulatory service's operation.
- 84% of responding general practitioners found the service beneficial, with 97% reporting easy access and prompt consultations.
- 98% of surveyed parents expressed satisfaction with the service, with 82% believing their child benefited from avoiding hospital admission.
Conclusions:
- A paediatric ambulatory assessment unit is an effective and acceptable alternative to inpatient care.
- The service successfully reduced hospital admissions while meeting the needs of children, families, and general practitioners.
- Implementing such ambulatory services can optimize pediatric healthcare resource utilization and improve patient and family experiences.
Abstract:
To determine whether a paediatric ambulatory assessment service is an effective and acceptable replacement for an inpatient unit. Analysis of hospital paediatric medical admissions. Postal questionnaire survey of local general practitioners. Telephone survey of parents of children who had attended the ambulatory service. Rural General Hospital in Northern Ireland. General practitioners. Parents of children referred to assessment service. Number of paediatric medical hospital admissions from the local area before and after the introduction of an ambulatory assessment service. General practitioner satisfaction levels. Parental satisfaction levels. Since the introduction of the new service in April 1996 there has been a marked progressive reduction in paediatric medical hospital admissions from the local area. By the third year of operation of the ambulatory service (1998/99), a 47% reduction in admissions was recorded, compared to the 1995/96 baseline year. The response rate to the general practitioner questionnaire was 65% (37 of 57) of whom most (31, 84%) found the service beneficial. Of the 37 respondents, 31 had referred patients to the service. The majority of these general practitioners (30, 97%) reported that the service was easy to access, and the same proportion felt that requests for consultation were met promptly. Most felt that feedback was appropriate (29, 94%). A telephone survey of 50 parents showed that most were either very satisfied (38, 76%), or satisfied (11, 22%) with the service. Most parents (41, 82%) felt their child had benefited by not being admitted to hospital. Most (46, 92%) felt they had received adequate information regarding their child's illness. A paediatric ambulatory assessment unit can reduce the number of children admitted to hospital and meet the needs of children, their families and general practitioners.
