[Alternative possibilities to emergency admissions to a medical department]

On the basis of a questionnaire to general practitioners who had referred 200 patients greater than or equal to 60 years as emergencies to a non-specialized medical ward, possible alternative possibilities to the emergency hospitalization are assessed. It proved possible to obtain information and replies about 175 patients who were, therefore, included in this investigation. As a considerable proportion of the socially-conditioned admissions occurred during daytime hours and these were referred by practitioners who knew their patients well (40% described themselves as knowing these patients very well) it was found that the referring practitioners were well aware of alternatives to emergency hospitalization. The practitioners referring the patients described 36 out of the 175 patients as socially-conditioned and 2/3 of these as sociomedically-conditioned. In agreement with this, the authors found that 70% of the socially-conditioned admissions had a concurrent somatic diagnosis most frequently in the form of pulmonary of cardiac disease. Nevertheless, the referring physicians considered that 33 (93%) of the admissions could either be be entirely avoided (81%) or that admission could be postponed (12%). The requisites for this were primarily easy access to nursing homes or to emergency home nursing facilities.