A reduction in hospitalization, length of stay, and hospital charges for croup with the institution of a pediatric observation unit

Am J Emerg Med. 2006 Nov;24(7):818-21. doi: 10.1016/j.ajem.2006.05.003.


Objectives: The aim of the study was to assess the impact of an observation unit (OU) on hospital resource utilization for patients with croup.

Methods: A retrospective review with the use of a historical control was performed for 2 years of nondischargeable emergency department (ED) patients with croup.

Results: The total number of ED patients with croup was 694 in the first year and 789 in the second year. Hundred seventy patients were enrolled, 66 in the first year and 104 in the second year (76 admitted to the OU and 33 admitted to the ward). There was a reduction in the ward admission rate from 9.5% to 4.2% (P < .0001) from the first to the second year. The median length of stay for the pre-OU group was 27.2 vs 21.3 hours for the post-OU group (P = .03). The median charge for the pre-OU group was $1685 vs $1327 for the post-OU group (P = .03).

Conclusions: After the introduction of the OU, hospitalization was reduced, and the overall resource utilization for the care of nondischargeable ED patients with croup was reduced.

MeSH terms

  • Child
  • Child, Preschool
  • Croup / therapy*
  • Emergency Service, Hospital / economics
  • Emergency Service, Hospital / organization & administration*
  • Female
  • Hospital Charges*
  • Hospital Units / economics
  • Hospital Units / organization & administration*
  • Humans
  • Infant
  • Length of Stay / economics
  • Length of Stay / statistics & numerical data*
  • Male
  • Patient Admission / economics
  • Patient Admission / statistics & numerical data*
  • Program Evaluation
  • Retrospective Studies