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.
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.
Entities:
Keywords:
emergency care systems, admission avoidance; emergency care systems, primary care
Authors: Xavier Bosch; Ona Escoda; David Nicolás; Emmanuel Coloma; Sara Fernández; Antonio Coca; Alfonso López-Soto Journal: BMC Fam Pract Date: 2014-04-28 Impact factor: 2.497