Changing patterns of psychiatric inpatient care for children and adolescents in general hospitals, 1988-1995.

Objective: The authors examine patterns in utilization of psychiatric inpatient services by children and adolescents in general hospitals during 1988-1995.

Method: National Hospital Discharge Survey data were used to describe utilization patterns for children and adolescents with primary psychiatric diagnoses in general hospitals from 1988 to 1995.

Results: During the study period, there was a 36% increase in hospital discharges and a 44% decline in mean length of stay, resulting in a 23% decline in the number of bed-days, from more than 3 million to about 2.

Impact on the care of the emergency department chest pain patient from the chest pain evaluation registry (CHEPER) study.

This study examines the question of whether chest pain observation units increase the proportion of chest pain patients with an extended evaluation for cardiac ischemia ("rule out myocardial infarction [MI] evaluation"), decrease the number of missed MIs, and decrease costs. This is a multiple site registry study of 8 established chest pain observation units (complying with the American College Emergency Physician's Observation Section's standards) compared with previous studies on chest pain evaluation without the use of observation (5 studies, 12,405 patients). A total of 23,407 of 444,189 emergency department patients (5.

Impact of the political violence in Natal on emergency surgical services of a tertiary hospital.

In order to investigate the impact of the political violence in Natal on a tertiary hospital's emergency surgical services, 5 days in February 1990 (based on newspaper reports of political violence) were identified and matched for the day of week and time of month to obtain comparable control days in February 1989. Data for each of the 10 days were obtained from casualty department attendance registers and a 40% random sample of emergency outpatients' charts. Comparing violence to control days, the total number of patients treated in casualty increased by 9.