Patient expectations of emergency hospital admission: a cross-sectional questionnaire survey

Emergency admissions are rising, but little is known about the patient perspective. We aimed to explore the views of patients assessed for admission in terms of (i) whether they expected to be admitted, (ii) the comfort, convenience and safety of admission and (iii) whether satisfaction with care was influenced by expectations of admission being met.

We undertook a cross-sectional survey of 200 patients who arrived by emergency ambulance and were assessed for the need for admission. Patients completed a questionnaire that recorded their expectations of hospital admission before a decision was made to admit or discharge and their satisfaction with the decision when it was made.

The study population was 63% (127/200) female, with a mean age of 61 years. Around 45 of 200 (22.5%) patients expected themselves to be admitted, whereas 85/200 (42.5%) were actually admitted. Responses indicated that 74.5% [95% confidence interval (CI) 68.0-80.0%] agreed or strongly agreed that they felt safer in hospital than at home, 47.5% (95% CI 40.7-54.4%) felt more comfortable in hospital and 86.0% (95% CI 81.1-90.6%) agreed that it would be easier to provide treatment for them if they were admitted. We found no evidence of an association between patient satisfaction and expectations being met in those expecting admission (P=0.301) or expecting discharge home (P=0.885).

Most patients being assessed for admission do not expect to be admitted, but most report positive views about the safety, comfort and convenience of hospital admission. We found no evidence of reduced satisfaction if expectations about admission are not met.