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Outpatient oral rehydration in the United States
Insights
Oral rehydration therapy is a safe and cost-effective method for treating dehydrated infants in outpatient settings. Utilizing a holding room in the emergency department significantly reduces healthcare costs and hospitalizations.
Area of Science:
- Pediatrics
- Emergency Medicine
- Gastroenterology
Background:
- Dehydration in infants due to acute gastroenteritis is a common pediatric concern.
- Intravenous rehydration is often the standard inpatient treatment, leading to prolonged hospital stays and higher costs.
Purpose of the Study:
- To compare the safety, efficacy, and cost-effectiveness of oral versus intravenous rehydration in infants.
- To evaluate the utility of an emergency department holding room for outpatient rehydration.
Main Methods:
- Prospective randomized study involving 29 dehydrated infants (3-24 months) with acute gastroenteritis.
- Comparison of oral rehydration solution (ORS) with standard intravenous therapy.
- Assessment of treatment outcomes, duration of care, and healthcare costs.
Main Results:
- Oral rehydration therapy successfully treated 13 out of 15 outpatients.
- Outpatient oral rehydration averaged 10.7 hours in a holding room versus 103.2 hours for inpatient intravenous therapy.
- Outpatient oral rehydration therapy was significantly less expensive than inpatient intravenous therapy ($272.78 vs $2,299.50).
Conclusions:
- Oral rehydration is a safe and cost-effective treatment for dehydrated infants in US outpatient settings.
- Implementing emergency department holding rooms can decrease healthcare costs and prevent unnecessary hospitalizations.
Abstract:
Twenty-nine dehydrated, well-nourished infants, who were 3 to 24 months of age and had acute gastroenteritis, were enrolled in a prospective randomized study that compared the safety, efficacy, and costs of oral vs intravenous rehydration. The study was designed to assess the use of a holding room in the emergency room for the outpatient rehydration of dehydrated infants. The oral solution that was used contained 60 mEq/L of sodium, 20 mEq/L of potassium, 50 mEq/L of chloride, 30 mEq/L of citrate, 20 g/L of glucose, and 5 g/L of fructose. Thirteen of 15 patients were successfully rehydrated orally as outpatients; two patients, who were subsequently discovered to have urinary tract infections, required hospitalization due to persistent vomiting. Orally rehydrated outpatients spent a mean of 10.7 hours in the holding room, as compared with intravenously rehydrated inpatients, who were hospitalized for a mean of 103.2 hours. Outpatient oral rehydration therapy was significantly less costly than inpatient intravenous therapy (+272.78 vs +2,299.50). Our results indicate that oral rehydration is a safe and cost-effective means of treating dehydrated children in an outpatient setting in the United States. The use of a holding room for observation in the emergency room can markedly decrease health care costs and unnecessary hospitalizations.