An Overview of an Emergency Department Short Stay Ward in Hong Kong

Abstract

Objectives To describe the structure and service pattern of a short stay ward (SSW) named as Emergency Observation and Pre-admission Ward (EOPW) in Hong Kong. The effectiveness of the EOPW was to be examined. Methods This was a retrospective observational cohort study. The facilities, staffing and operation of the EOPW were described. Consecutive patients admitted to the EOPW in the year 2006 were retrieved from the hospital computer database. Admission diagnoses, length of stay (LOS) and destination of disposal were the main outcome variables measured. The ICD coded admission diagnoses were categorised into 24 diagnosis-related groups. Different diagnosis-related groups were compared with respect to the selected efficacy cutoff points of LOS less than 24 hours and hospital admission rate less than 30% respectively. Results The service of the 30-bed short stay ward as started in year 2003 was a pilot project in Hong Kong. In year 2006, 10,111 patients were admitted and the mean age was 54.2 years. The five commonest diagnosis-related groups were psychiatric disease, chest pain, dizziness, musculoskeletal pain and poisoning. The overall hospital admission rate and the mean LOS were 26.8% and 23.4 hours respectively and were below the efficacy cutoff points. Musculoskeletal pain, chronic obstructive pulmonary disease and acute urinary retention were the three diagnostic groups with both LOS and hospital admission rate above the efficacy cutoff points. Conclusion This first SSW in Hong Kong was demonstrated to be effective according to the analysis result of the 2006 data. SSW has become an integral part of emergency medicine and provided an alternative way of effective management in contrast to traditional inpatient management for various selected disease conditions.