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Acute hospital utilisation study: final report for University College Hospital, Galway.
Glacken, Marita; Evans, David S.
The study undertook an examination of acute hospital utilisation by patients over 65 years of age within the Western Health Board. It aimed to provide an insight into areas where acute hospitals could be utilised more effectively in order to provide the patient with the right service in the right place and at the right time. The study focused on the over 65 age group as they accounted for the longest length of stay in hospital, and as such had the greatest potential for improvement. The measurement of hospital utilisation was undertaken using the Appropriateness Evaluation Protocol (AEP) which identified the extent of and reasons for the unnecessary utilisation of hospitals. The AEP has been extensively tested and has been found to be a valid and reliable review instrument. The protocols were administered by research nurses who were recruited specifically to complete the questionnaires and to process data. The protocols were administered on medical and surgical admissions, elective surgical admissions, and days of care for patients (excluding day cases) aged 65 years and over in the four key hospitals offering acute care within the Western Health Board. The results of the study demonstrated that in UCHG: 10% of medica1-surgical admissions are inappropriately placed. Booked admissions have a higher level of inappropriate placement compared with emergency admissions (32% compared to 3 %). Booked admissions were inappropriately admitted to expedite investigations (which are normally undertaken on an outpatient basis) or to avail of intensive paramedical therapy not available at outpatient level Some booked patients are also admitted inappropriately because of the unavailability of respite or long stay beds. Others are admitted because the service they require is not yet available at UCHG as a day service. Emergency admissions that were inappropriately placed could either have been handled on an outpatient basis, needed access to community support services, or admission to a residential or a respite service. Elective surgical patients accounted for 28% of admissions. Thirty two percent of elective surgical admissions were considered to be inappropriately located as they could have been dealt with on a day case basis.
Keyword(s): HOSPITAL ADMISSION; OLDER PEOPLE
Publication Date:
1999
Type: Report
Peer-Reviewed: Unknown
Language(s): English
Contributor(s): Western Health Board. Department of Public Health.
Institution: Lenus
Publisher(s): Western Health Board. Department of Public Health.
First Indexed: 2014-04-03 06:33:51 Last Updated: 2017-05-11 05:54:03