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Comment & Response |

Dedicated Observation Unit for Patients With “Observation Status”—Reply

Ann M. Sheehy, MD, MS1
[+] Author Affiliations
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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In Reply Ross and Hockenberry describe how protocols have been used to improve the efficiency of observation units in emergency departments. Data from observation units in emergency departments,1 however, cannot be used to compare costs and lengths of stay for the entire spectrum of observation care at a hospital. From emergency department observation units, there are randomized trials for patients with chest pain, asthma, transient ischemic attack, atrial fibrillation, and syncope.1 At our hospital, however, patients with these 5 diagnoses account for only about 20% of patients with observation status. In our study, patients hospitalized for observation had 1141 different diagnosis codes.2


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February 1, 2014
Michael A. Ross, MD; Jason M. Hockenberry, PhD
1Department of Emergency Medicine, Emory University, Atlanta, Georgia
2Department of Health Policy and Management, Emory University, Atlanta, Georgia3Department 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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