Acute hospital admission systems: problems experienced by general practitioners

This study was undertaken to examine the existing system of access for general practitioners in arranging acute admissions to three general hospitals in the Southern Health Board (SHB) area. One hundred and twenty eight patients were admitted to the three hospitals over a one week period. General practitioners were surveyed on the process of admission for each patient. Response rate was 118/128 (92.2%). Hospital A had 53 admissions, Hospital B had 41 admissions and Hospital C had 24 admissions. In total, 30/118 (25.4%) admissions took over one hour to arrange, of these 23 (76.7%) were admitted to Hospital A, 4 (13.3%) were admitted to Hospital B and 3 (10.0%) were admitted to Hospital C. The admission sister was responsible for confirming the route of admission in 102 (86.4%) of cases. In Hospital A, 23/53 (43.4%) patients were referred to Accident and Emergency (A&E) for assessment prior to admission, 4/41 (9.8%) were referred in Hospital B, and 2/24 (8.3%) in Hospital C. In the light of current findings, possible alternatives to the current acute admissions system are discussed.