Health impact of hospital restrictions on seriously ill hospitalized patients: lessons from the Toronto SARS outbreak.
Med Care
; 46(9): 991-7, 2008 Sep.
Article
en En
| MEDLINE
| ID: mdl-18725855
ABSTRACT
BACKGROUND:
Restrictions on non-urgent hospital care imposed to control the 2003 Toronto severe acute respiratory syndrome outbreak led to substantial disruptions in hospital clinical practice, admission, and transfer patterns.OBJECTIVES:
We assessed whether there were unintended health consequences to seriously ill hospitalized patients. STUDY DESIGN, SETTING, AND POPULATION Population-based longitudinal cohort study of patients residing in Toronto or an urban control region with an incident admission for 1 of 7 serious conditions in the 3 years before, or the 4 months during or after restrictions. OUTCOMEMEASURES:
Short-term mortality, overall readmissions, cardiac readmissions for acute myocardial infarction patients, serious complications for very low birth weight babies, and quality of care measures, comparing adjusted rates across time periods within regions.RESULTS:
Mortality, readmission, and complication rates did not change for any condition during or after severe acute respiratory syndrome restrictions. Although rates of invasive cardiac procedures for acute myocardial infarction patients decreased 11-37% in Toronto, rates of nonfatal cardiac outcomes did not change.CONCLUSIONS:
Restrictions on non-urgent hospital utilization and hospital transfers may be a safe public health strategy to employ to control nosocomial outbreaks or provide hospital surge capacity for up to several months, in large, well-developed healthcare systems with good availability of community-based care.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Admisión del Paciente
/
Readmisión del Paciente
/
Infección Hospitalaria
/
Brotes de Enfermedades
/
Transferencia de Pacientes
/
Mortalidad Hospitalaria
/
Síndrome Respiratorio Agudo Grave
/
Política de Salud
/
Accesibilidad a los Servicios de Salud
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
/
Newborn
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Med Care
Año:
2008
Tipo del documento:
Article
País de afiliación:
Canadá