Differences between self-referred and physician-referred hospital admissions

Compare self- and physician-referred hospital admissions.

Analysis of data prospectively collected on 3,076 consecutive acute medical admissions to a small hospital.

Self-referred patients were younger (50.6 vs. 63.7 years) and more likely to be smokers and drinkers. Conversely, physician-referred patients were more likely to present later, be ex-smokers, ex-drinkers and have poor prior health. More self-referred admissions were related to parasuicide and/or alcohol (27% vs. 4.5%). The physical, x-ray and laboratory findings of both types of patient were similar. Although self-referred patients had a shorter length of stay (3.8 days vs. 6.0 days) and a lower death rate (1.5% vs. 3.8%),they had higher 30-day readmission rates (14.6% vs. 8.5%).

Self-referred patients are less sick than those referred for hospital admission by a physician, have less psychosocial support, more alcohol-related illness and are nearly twice as likely to be readmitted within 30 days of discharge