Emergency medical admissions to hospital--the influence of supply factors

A retrospective review of all adult medical in-patient hospital records in one health district (adult population 378,000) was performed over three consecutive years. Yearly age-standardised rates for emergency admissions were calculated and compared between sections of the population with differing access to hospital beds. Confounding and other explanatory variables were examined with a logistic regression model. Emergency medical admission rates were consistently higher in the population whose general practitioner had access to community hospital beds, as compared with those whose general practitioner had no access, (46.1 per thousand population vs 39.3 per thousand in the year 1994-95, difference significance, P < 0.05). Multivariable analysis suggests that in addition to supply factors, age, sex, morbidity and socio-economic circumstance influence admission rates.