Children's Hospitals Often Do Little to Offset High Occupancy

Hospitals experience crowding often, but rate of acute response to high occupancy is low

WEDNESDAY, April 21 (HealthDay News) -- Among children's hospitals, there is a low rate of acute response to high occupancy, and the magnitude of response is small in those that do respond, according to research published online April 19 in Pediatrics.

Evan S. Fieldston, M.D., of the University of Pennsylvania School of Medicine in Philadelphia, and colleagues studied 2006 midnight census data from 39 children's hospitals to construct occupancy levels. They used changes in hospital admissions, transfers, and lengths of stay to measure acute response to high occupancy.

The researchers found that hospitals frequently experienced crowding, with 28 percent of midnights at 85 to 94 percent occupancy and 42 percent of midnights at 95 percent occupancy or higher. When occupancy was at least 95 percent, 8 percent of hospitals or fewer took measures to reduce the number of admissions, 13 percent increased transfers out, and up to 58 percent reduced length of stay. The researchers determined that half of the hospitals used occupancy-mitigating responses, but there was variability in responses and magnitudes were small.

"We found that among 39 children's hospitals, meaningful responses to high occupancy were rare, in that they would not substantially reduce inpatient crowding. Given that studies in adult hospitals have found increases in sentinel events and medical errors associated with crowding, our findings raise concerns about adverse effects on patient safety and quality of care in the pediatric inpatient population," the authors write.

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