Severity of sickness at admission to hospital in Colchester 1985 and 1990

In 1991 concern was expressed by hospital physicians and general practitioners about hospital services in Colchester, Essex, following a period of declining real resources. One focus of complaints was that over a period of about five years it had become increasingly difficult to admit acutely ill medical patients. We wished to obtain some objective data to corroborate or refute this anecdotal evidence. We therefore studied the severity of illness at admission in a random sample of emergency admissions for acute chest problems in 1985 and 1990. The main finding was that APACHEII scores were significantly higher (P = 0.002) in the 1990 sample than in the 1985 sample. These objective data contributed to a decision to allocate pounds 100,000 extra funding to the acute medical service in 1991-92.