Authors (including presenting author) :
LEE WK, LAW KL
Affiliation :
Accident and Emergency Department, North District Hospital
Introduction :
There is no paediatric in-patient service in North District Hospital (NDH). Patients under the age of 18 years are transferred to other hospitals in the cluster if hospitalizations are required for acute medical problems. A locum paediatric specialist was recruited in order to improve the acute paediatric medical service in the Accidental and Emergency Department (AED) and optimize the utilization of hospitalizations.
Objectives :
The characteristics of the patients, who were followed up in the Paediatric Ambulatory Care (PAC) in AED, and their subsequent utilization of medical services are described in this presentation.
Methodology :
Options of PAC are provided to patients presenting to AED of NDH with relative indications of admission to Paediatrics Ward. If parents agree, relevant microbiological investigations are done in AED and the patients are followed up by the locum specialist within the next one to two days. The data of clinical and microbiological diagnoses, number of visits in the PAC, admission rate, antibiotic prescription etc. are collected.
Result & Outcome :
The preliminary data in the first 8 months of the one-year project period were as follows: (1) Median age of the patients was 4.7 years. (2) Acute upper respiratory tract infection was the most common clinical diagnosis (31.9%). (3) Influenza A was the most common microbiological diagnosis (23.6%). (4) 73.8%, 20.1%, 5.2% and 0.9% of the patients were followed up for one, two, three and four times respectively in PAC. (5) Admission rate of the patients who had been followed up in PAC was 8.7%. (6) Admission rate of all paediatric patients with medical problems in this period was 20.9%, which was lower than an earlier 3-year (Apr 2017 to Mar 2020) period (22.6%) and another 3-year (Apr 2020 to Mar 2023) period (27.0%). (7) Antibiotic prescription before or after the first PAC visit was 37.6%.
