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Every seventh acute medical admission is preventable
Henrik Koldborg Jepsen1, Carsten Hendriksen, Henrik Nielsen
1Department of Endocrinology and Gastroenterolog, Bispebjerg Hospital, 2400 Copenhagen NV, Denmark. hksnit@gmail.com
Danish Medical Journal
|March 15, 2013
Summary
Approximately 14% of acute internal medicine admissions were inappropriate and could have been prevented. Preadmission examination did not significantly impact admission appropriateness, suggesting alternative care pathways are needed.
Area of Science:
- Internal Medicine
- Healthcare Management
- Patient Flow Optimization
Background:
- Most internal medicine admissions are acute.
- Evaluating admission appropriateness is crucial for resource allocation.
Purpose of the Study:
- To assess the appropriateness of acute internal medicine admissions at a community hospital.
- To identify potential areas for improvement in patient admission processes.
Main Methods:
- A three-week consecutive sample of acute medical admissions was evaluated.
- The Appropriateness Evaluation Protocol (AEP) was used for retrospective assessment.
- Admissions were categorized as appropriate or inappropriate by physicians.
Main Results:
- 14% of 470 acute admissions were deemed inappropriate.
- 30% of patients were discharged within 24-48 hours, with 42 of these inappropriately admitted.
- No significant link was found between preadmission examination and appropriateness.
Conclusions:
- 14% of acute admissions could have been avoided.
- Alternative care settings like diagnostic units or outpatient clinics may be suitable for some patients.
- The AEP is a useful screening tool but requires complementary methods for comprehensive evaluation.
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