Respiratory day hospital: a novel approach to acute respiratory care

IN 1996 WE ESTABLISHED A DAY HOSPITAL DEDICATED to acute respiratory care, as an alternative to emergency department and inpatient treatment. The unit is staffed by respirologists, family physicians and specialized nurses; pa tients have access to all standard inpatient treatments and services. Betwe en 1996/97 and 1998/99 the annual number of admissions to the day hospital increased from 658 to 922. By 1998/99 more than 75% of patients were referr ed for acute treatment, with a mean stay of 2.3 days. The most common diagn oses were asthma and chronic obstructive pulmonary disease, which accounted for 58% and 32% respectively of treatment-related admissions. Treatment mo st often involved intravenous corticosteroid therapy and inhaled bronchodil ator therapy. Between 1996/97 and 1998/9 the proportion of patients requiri ng transfer to overnight care decreased from 22% to 14%; complications and unscheduled return visits were rare. We believe that a respiratory day hosp ital provides a useful alternative to emergency department and inpatient ca re.