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Avoidable emergency admissions?
Emerg Med J. 2013 Sep;30(9):707-11
Authors: Lillebo B, Dyrstad B, Grimsmo A
Abstract
BACKGROUND: Use of specialist healthcare services is increasing.
AIM: To evaluate whether alternative healthcare services could reduce the need for admissions to specialist care hospitals.
DESIGN: Prospective observational study of emergency referrals for admission to specialist care.
SETTING: A single out-of-hours primary care centre (OPCC) in Norway.
METHOD: Out-of-hours physicians registered their referrals for hospital admission and stated whether the admission could have been avoided given the availability of six other healthcare services.
RESULTS: Of 1083 registered encounters at the OPCC, 152 (14%) were referred for specialist care hospital admission. According to the referring physician, 32 (21%) of these referrals could have been avoided. The most eligible alternatives to such referrals were next-day appointments at a specialist outpatient clinic (11 of 32 referrals), or admission to a community hospital (21 of 32 referrals), or a nursing home (nine of 32 referrals). Respiratory (eight of 32 referrals) and gastrointestinal problems (12 of 32 referrals) were the most common among avoidable admissions.
CONCLUSIONS: The use of specialist care hospital admission can be reduced if appropriate alternatives are available.
PMID: 22983980 [PubMed - indexed for MEDLINE]