Abstract

Study design: Observational retrospective study.

Background: The present work was aimed to determine if the founding of a day patient facility (DPT) was able to optimize inpatient (IP) effectiveness measures and if there were differences in the patient’s clinical profile depending on the modality of care. Setting: Pediatric Unit of the Hospital Nacional de Parapléjicos of Toledo (Spain).

Methods:All the children attended, both IP and outpatient, were analyzed throughout two different years: 2006, the year immediately prior to the start-up of the DPT facility, and 2015, ten years after its foundation. A descriptive and inferential statistical analysis was performed for the study purpose.

Results: In 2006, there were different 75 inpatient children treated. From the 156 patients attended in 2015, 16.7% reported receiving IP regime, 61.5% DPT regime, and 21.8% in combined modality (CM). The average age of DPT was significantly lower than IP (P<0.01). Almost half of IPs processes exhibited AIS A SCI in both years (46.7% in 2006, and 46.2% in 2015), while a 67.7% of DPT patients showed AIS C or D in 2015. With respect of the hospitalization activity monitoring, we found that the presence of a DPT involved an increase in the IP average length of stay (from 20.83 to 39.78 days) and bed occupancy (from 27.72% to 42.04%) with a decrease in the bed turnover (from 4.86 to 3.86).

Conclusion:A DPT facility is able to improve the healthcare of pediatric SCI children by optimizing the use of IP resources.