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Comment & Response |

Dedicated Observation Unit for Patients With “Observation Status”

Michael A. Ross, MD1; Jason M. Hockenberry, PhD2,3
[+] Author Affiliations
1Department of Emergency Medicine, Emory University, Atlanta, Georgia
2Department of Health Policy and Management, Emory University, Atlanta, Georgia
3Department of Veterans Affairs (VA) Center for Comprehensive Access Delivery Research and Evaluation, Atlanta, Georgia
JAMA Intern Med. 2014;174(2):301. doi:10.1001/jamainternmed.2013.13485.
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To the Editor Sheehy and colleagues1 detail the financial losses associated with patients admitted to “observation status” at an academic medical center.

It is noteworthy that the study hospital does not have a dedicated observation unit, despite an average of more than 8 patients a day receiving observation care, a volume of patients that could easily support such a unit. Eight prospective randomized trials have shown lower costs and length of stay for patients in observation units compared with those admitted as inpatients for conditions such as chest pain, asthma, transient ischemic attack, and atrial fibrillation.2,3 There have also been several single center studies of the many conditions managed in observation units, showing that lengths of stay are comparable to those reported in randomized trials.2,3


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February 1, 2014
Ann M. Sheehy, MD, MS
1Division of Hospital Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison
JAMA Intern Med. 2014;174(2):301-302. doi:10.1001/jamainternmed.2013.13477.
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