Throughput in a department of geriatric medicine: a problem of time, space, and behaviour.

Over a period of 16 years, the annual admissions to the Merton part of the St George's Department of Geriatric Medicine increased, then decreased, before rising again. Examination of the mean length of stay and bed turnover indicated that patient management was continually changing. However, this was not confirmed by a percentile analysis of the pattern of length of stay after admission. Present plans for hospital medical services for elderly people are based on the hypothesis that length of stay shortens linearly with time. The results of this study do not support this hypothesis. They do, however, imply the need to regularly review the policies for the medical care of elderly people.