Abstract:
Introduction: Children are universally acknowledged as a vulnerable demographic, warranting specific rights and protections aimed at ensuring their health, well-being, and holistic development (1,2). Partial hospitalization— commonly referred to as the "day hospital" model—constitutes an innovative approach within pediatric healthcare. Originating in the United States during the 1980s as part of mental health deinstitutionalization initiatives, this model has since been adapted to a variety of clinical domains (3,4). As an intermediate level of care, it bridges outpatient services and full inpatient hospitalization by allowing patients to reside at home overnight while attending structured and intensive therapeutic sessions during the day. This hybrid modality facilitates continuity of care, promotes efficient use of healthcare resources, and enhances patient adherence to treatment regimens (4). In Colombia, particularly in Bogotá D.C.—a high-altitude city at 2,600 meters above sea level—the seasonal surge in pediatric respiratory illnesses places a considerable burden on healthcare infrastructure, characterized by increased admission rates, prolonged hospital stays, and elevated morbidity and mortality among children. In this context, the day-hospital model emerges as a viable strategy to sustain the quality of care amid elevated service demands (1–5).
Methodology: A prospective cohort study was conducted on a Pediatric Day-Hospital pilot program at the Santa María del Lago Children's Clinic in Bogotá, Colombia, launched on March 19, 2025. The program provides comprehensive management, treatment, and follow-up of acute pediatric conditions through a hybrid model combining in-person care and home telemonitoring.
Results: During a 124-day observation period, a total of 1,943 care episodes were documented for 33 pediatric patients managed through the hybrid modality, with 61.7% of encounters conducted via teleconsultation and 38.2% occurring onsite. The mean duration of participation in the program was 4.98 days, and the readmission rate was 3.3%. Respiratory pathologies constituted the primary reason for care, representing 79.7% of total cases. Patients were referred almost equally from emergency services (48.9%) and inpatient units (51.0%). The program effectively optimized 1,943 bed-days, indicating a theoretical capacity to serve up to 138 patients per month.
Conclusions: The Pediatric Day Hospital model demonstrated both safety and clinical efficacy in the management of acute pediatric conditions. Its applicability may extend to other disease entities and broader pediatric age groups. Moreover, the model’s scalability and impact could be further enhanced through expanded use of home-based telemonitoring and the incorporation of artificial intelligence-driven tools to support caregivers and optimize clinical decision-making processes.
