Are short-stay admissions to an acute general medical unit appropriate? Wellington Hospital experience

N Z Med J. 1998 Aug 28;111(1072):314-5.

Abstract

Aim: This audit was performed to ascertain whether the admission of patients to the General Medical Unit (Wellington Hospital) for one day or less was appropriate.

Methods: Between 1 July 1996 and 30 June 1997, 494 patients were admitted to General Medicine for one day or less. The medical records for a random sample of 245 patients were reviewed. A modification of the Oxford Bed Study Instrument was used to assess the appropriateness of admission.

Results: Twenty admissions (8.2%) were deemed inappropriate, six patients could have been referred to medical outpatients, four were known epileptics who presented following a seizure, and none of the others merited admission on severity criteria. Ten patients were triaged after 10.00 pm, when discharge becomes more difficult. Forty-two patients required an investigation which delayed discharge.

Conclusion: With the present community and investigation facilities available, there is no evidence that the majority of 24-hour admissions to acute General Medicine are inappropriate.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Health Services Misuse / statistics & numerical data*
  • Hospital Units / statistics & numerical data*
  • Hospitals, Teaching
  • Humans
  • Internal Medicine
  • Length of Stay / statistics & numerical data*
  • Male
  • Medical Audit
  • Middle Aged
  • New Zealand
  • Patient Admission / standards*
  • Referral and Consultation
  • Severity of Illness Index
  • Time Factors
  • Triage
  • Utilization Review