Why people are hospitalized. A description of preventable factors leading to admission for medical illness.

We evaluated factors leading to the admission of 136 patients to the general medical services of two large metropolitan hospitals. We developed explicit criteria for the contribution of various specific factors to illness prevention and control in these patients. According to these criteria, the illness was found to be preventable in 44 per cent and the illness could have been controlled without admission in 31 per cent if a standard medical regimen had been followed. Social circumstances of individual patients influenced the admission decision in 21 per cent. Lack of medical or community resources or failure to make use of them contributed to 21 per cent of admissions. Alcohol abuse and smoking were factors in 17 per cent and 15 per cent respectively. Compliance played a role in 21 per cent. In 29 per cent of admissions more than one preventable factor was identified. Personal habits and lifestyle, less-than-optimal management or prior illness, social considerations or lack of community resources were factors in 78 per cent of the admissions.