My objective was to revisit the issues and approaches raised in a seminal article published in Pediatrics in 1976 by A. Frederick North, Jr, entitled « When Should a Child Be in the Hospital ? » Dr North proposed a set of nine criteria to guide the evaluation of appropriateness of admission to hospital.
These were based on a core assertion that, « The need to hospitalize a child is dependent on the special services which the child requires rather than upon the diagnosis. » This original work antedated more recent activities and publications in the area of appropriateness evaluation as applied to pediatrics (such as the Pediatric Appropriateness Evaluation Protocol), but is more context-specific than later works in the field.
A review of the literature concerning temporal trends in hospital use for children in North America was undertaken.
This was done to place some of the subsequent observations in a macrocontext of overall trends in hospital use.
A review of the English language literature focusing on alternatives to hospitalization and contextual evolution affecting patterns of hospital care for children is presented.
Factors influencing each of the nine admission criteria proposed by North are reviewed and discussed in turn.
Overall rates of hospitalization declined by 46% and 41% in the United States and Canada, respectively, during the 1971 to 1993 interval. (...)
Mots-clés Pascal : Hospitalisation, Indication, Besoin, Maladie, Revue bibliographique, Amérique du Nord, Amérique, Etude cohorte, Enfant, Homme
Mots-clés Pascal anglais : Hospitalization, Indication, Need, Disease, Bibliographic review, North America, America, Cohort study, Child, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0090837
Code Inist : 002B30A01C. Création : 14/05/1998.