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Source: http://canadianpress.google.com/article/ALeqM5h0lHp6C5SgMUZPppoccttxbyJncg
No collateral damage to non-SARS patients during SARS outbreak: study
TORONTO ? Patients with serious health conditions who had to be hospitalized during Toronto's SARS outbreak didn't appear to suffer from being in hospital during that stressful and chaotic time, a new study suggests.
The authors say the findings show the restrictions placed on Toronto hospitals during the SARS outbreak in 2003 were not detrimental to patients over the long term and could be used to contain future disease outbreaks.
"As a policy to restrict non-urgent hospital-based care, whether it's admissions or ambulatory care or transfers, it's a safe strategy," said Therese Stukel, lead author of the study and a senior scientist at Toronto's Institute for Clinical Evaluative Sciences.
"It curbed the epidemic and there was no collateral damage to other patients."
The study is published in the September issue of the journal Medical Care.
Stukel and her colleagues studied data on patients admitted to hospital with seven serious health conditions during the three years before and four months during and after the SARS outbreak to see whether the limitations placed on Toronto hospitals had a negative impact on the health of people in them.
They compared Toronto patients to patients with the same health conditions hospitalized in Ottawa and London, Ont., where hospitals were not under the restrictions put in place in Toronto.
Those constraints included limiting admissions to only the most seriously ill and cutting back on hospital-to-hospital transfers, a common practice but one that seeded SARS outbreaks in a number of Toronto hospitals in the early days of the city's outbreak.
The researchers looked at rates of death and hospital readmissions within these groups of patients, figuring if deaths spiked or readmissions rose in the Toronto patients during the outbreak, it would be a sign that the level of care had suffered.
They had anticipated that for at least some of the types of patients they studied, the restrictions might have had a negative impact on the calibre of care.
They hypothesized that for four conditions - hip fracture, gastrointestinal bleeds, hemorrhaging in the brain and heart attack - that there would be no differences in the numbers because care in these cases doesn't generally require transfer to other hospitals.
But for three others - pulmonary embolism (blood clot in the lung), respiratory cancer and very low birth weight births - they thought the rate of adverse outcomes might have been higher, because transfer to specialty care units is often required.
"But we were actually surprised by what we found. We didn't find any adverse events in any conditions," Stukel said.
"It's rather impressive that the hospital staff and the nurses and physicians and infection control people largely managed to provide essential care, in the way they always do it."
The study is a companion to an earlier piece of research done by the same team that looked at whether instructing the public only to go to hospital for serious health problems had the intended effect during the SARS outbreak.
That study, published in 2004, found that the policy gave rise to an informal but effective triage system, where elective procedures like vasectomies dropped off sharply but care was still sought for serious conditions.
Both studies used hospital records; the researchers did not speak to people who were actually in hospital at the time of the outbreak. That means they could not measure the effect the restrictions had on the psychological well-being of people hospitalized during SARS, when visitors were barred from hospitals.
Stukel said the findings should be instructive for people planning for a flu pandemic, though she acknowledged that kind of outbreak would ignite substantially more illness than SARS did.
"In the case of large flu pandemic, we might need more rigorous restrictions. And we might need more surge capacity," she said. "That would require probably larger restrictions."
No collateral damage to non-SARS patients during SARS outbreak: study
TORONTO ? Patients with serious health conditions who had to be hospitalized during Toronto's SARS outbreak didn't appear to suffer from being in hospital during that stressful and chaotic time, a new study suggests.
The authors say the findings show the restrictions placed on Toronto hospitals during the SARS outbreak in 2003 were not detrimental to patients over the long term and could be used to contain future disease outbreaks.
"As a policy to restrict non-urgent hospital-based care, whether it's admissions or ambulatory care or transfers, it's a safe strategy," said Therese Stukel, lead author of the study and a senior scientist at Toronto's Institute for Clinical Evaluative Sciences.
"It curbed the epidemic and there was no collateral damage to other patients."
The study is published in the September issue of the journal Medical Care.
Stukel and her colleagues studied data on patients admitted to hospital with seven serious health conditions during the three years before and four months during and after the SARS outbreak to see whether the limitations placed on Toronto hospitals had a negative impact on the health of people in them.
They compared Toronto patients to patients with the same health conditions hospitalized in Ottawa and London, Ont., where hospitals were not under the restrictions put in place in Toronto.
Those constraints included limiting admissions to only the most seriously ill and cutting back on hospital-to-hospital transfers, a common practice but one that seeded SARS outbreaks in a number of Toronto hospitals in the early days of the city's outbreak.
The researchers looked at rates of death and hospital readmissions within these groups of patients, figuring if deaths spiked or readmissions rose in the Toronto patients during the outbreak, it would be a sign that the level of care had suffered.
They had anticipated that for at least some of the types of patients they studied, the restrictions might have had a negative impact on the calibre of care.
They hypothesized that for four conditions - hip fracture, gastrointestinal bleeds, hemorrhaging in the brain and heart attack - that there would be no differences in the numbers because care in these cases doesn't generally require transfer to other hospitals.
But for three others - pulmonary embolism (blood clot in the lung), respiratory cancer and very low birth weight births - they thought the rate of adverse outcomes might have been higher, because transfer to specialty care units is often required.
"But we were actually surprised by what we found. We didn't find any adverse events in any conditions," Stukel said.
"It's rather impressive that the hospital staff and the nurses and physicians and infection control people largely managed to provide essential care, in the way they always do it."
The study is a companion to an earlier piece of research done by the same team that looked at whether instructing the public only to go to hospital for serious health problems had the intended effect during the SARS outbreak.
That study, published in 2004, found that the policy gave rise to an informal but effective triage system, where elective procedures like vasectomies dropped off sharply but care was still sought for serious conditions.
Both studies used hospital records; the researchers did not speak to people who were actually in hospital at the time of the outbreak. That means they could not measure the effect the restrictions had on the psychological well-being of people hospitalized during SARS, when visitors were barred from hospitals.
Stukel said the findings should be instructive for people planning for a flu pandemic, though she acknowledged that kind of outbreak would ignite substantially more illness than SARS did.
"In the case of large flu pandemic, we might need more rigorous restrictions. And we might need more surge capacity," she said. "That would require probably larger restrictions."