Medical decision making : an international journal of the Society for Medical Decision Making
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Time series model to predict burden of viral respiratory illness on a pediatric intensive care unit.
In the United States, viral respiratory infections are a leading cause of illness and hospitalization in young children. Caring for children with severe viral respiratory illness can have a substantial impact on resource utilization in the pediatric intensive care unit (PICU). The objective was to build a robust model that captures the periodicity of severe pediatric viral respiratory illness and forecasts the incidence of viral respiratory illness in the PICU. ⋯ The identified model, derived from historical data from both a PICU and the local community, produced accurate 1-month and 3-month forecasts of severe viral respiratory illness presentation to the PICU. These results suggest that time series models may be useful tools in forecasting the burden of severe viral respiratory illness at the institutional level, helping institutions make decisions to optimize the distribution of resources.
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In 2002, Belgium saw the enactment of 3 laws concerning euthanasia, palliative care, and patient rights that are likely to affect end-of-life decision making. This report examines trends in the occurrence and decision-making process of end-of-life practices in different patient groups since these legal changes. A large-scale retrospective survey in Flanders, Belgium, previously conducted in 1998 and 2001, was repeated in 2007. ⋯ Physicians consulted their colleagues more often than in previous years for euthanasia and nontreatment decisions. The euthanasia law and emerging palliative care culture have substantially affected the occurrence and decision making for end-of-life practices in Belgium. Efforts are still needed to encourage shared end-of-life decision making, as some patients would benefit from advance care planning.