Avoidable emergency admissions?

作者：Lillebo Borge^*; Dyrstad Bodil; Grimsmo Anders

来源：Emergency Medicine Journal, 2013, 30(9): 707-711.

DOI：10.1136/emermed-2012-201630

• emergency care systems
• admission avoidance
• emergency care systems
• primary care

Background %26lt;br%26gt;Use of specialist healthcare services is increasing. %26lt;br%26gt;Aim %26lt;br%26gt;To evaluate whether alternative healthcare services could reduce the need for admissions to specialist care hospitals. %26lt;br%26gt;Design %26lt;br%26gt;Prospective observational study of emergency referrals for admission to specialist care. %26lt;br%26gt;Setting %26lt;br%26gt;A single out-of-hours primary care centre (OPCC) in Norway. %26lt;br%26gt;Method %26lt;br%26gt;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. %26lt;br%26gt;Results %26lt;br%26gt;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. %26lt;br%26gt;Conclusions %26lt;br%26gt;The use of specialist care hospital admission can be reduced if appropriate alternatives are available.

• 出版日期2013-9