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[Ambulatory pediatrics in the hospital and at home]
1Hôpital des Enfants Reine Fabiola, Bruxelles.
Insights
Pediatric ambulatory care, including extended dispensaries and home care, can reduce hospitalizations. However, budget cuts led to the closure of a home care unit, highlighting the need for sustained funding for these essential services.
Area of Science:
- Pediatrics
- Healthcare Management
Background:
- Hospitals provide ambulatory care through out-patient departments and emergency units.
- In urban areas, hospitals are the most accessible healthcare structures, especially considering socio-economic factors and parental availability.
- Common pediatric illnesses, primarily infectious and respiratory, often burden emergency units.
Purpose of the Study:
- To advocate for an alternative ambulatory care structure combining extended-timetable dispensaries and appointment-based out-patient clinics.
- To highlight the benefits of a complementary home care unit for pediatric patients.
- To emphasize the importance of integrated pediatric healthcare models in reducing hospitalizations and improving care quality.
Main Methods:
- The study describes an integrated pediatric ambulatory care model.
- This model includes out-patient departments, emergency units, extended dispensaries, appointment-based clinics, and home care units.
- The focus is on optimizing care for common pediatric illnesses to prevent unnecessary hospitalizations.
Main Results:
- The proposed ambulatory care structure aims to shorten or avoid hospitalizations.
- Home care units offer medico-social support, follow-up, and training, particularly beneficial in disadvantaged settings.
- The model improves treatment quality and provides comprehensive family support.
Conclusions:
- An integrated pediatric ambulatory care system with extended hours and home care offers significant advantages.
- This model can enhance care quality, reduce hospital burden, and provide crucial support to families.
- The suppression of such services, as seen with the Hôpital Saint-Pierre home care unit in 1983 due to budget cuts, underscores the vulnerability of these programs.
Abstract:
In paediatrics, ambulatory care under hospital control is ensured both by the out-patient department and by the emergency unit. If socio-economic level and parental availability are taken into account, the hospital remains the most accessible health-care structure in large towns. The common illnesses, in most cases infectious and respiratory, should not encumber the emergency unit, but should instead be taken in charge by a structure where an extended-timetable dispensary and an out-patient clinic by appointment work in parallel. In the most favourable cases, a home care unit completes this out-patient structure. Its main characteristics are as follows: it is exclusively paediatric, and it aims at shortening or avoiding hospitalization. It improves the quality of treatment, provides the family with medico-social support and follow-up that is particularly useful in less favoured settings, and can also offer preliminary training in heavy or chronic cases. Notwithstanding its obvious advantages, budgetary cuts have led to the suppression of home care at Hôpital Saint-Pierre in 1983.