Are short-stay admissions to an acute general medical unit appropriate? Wellington Hospital experience

This audit was performed to ascertain whether the admission of patients to the General Medical Unit (Wellington Hospital) for one day or less was appropriate.

Between 1 July 1996 and 30 June 1997, 494 patients were admitted to General Medicine for one day or less. The medical records for a random sample of 245 patients were reviewed. A modification of the Oxford Bed Study Instrument was used to assess the appropriateness of admission.

Twenty admissions (8.2%) were deemed inappropriate, six patients could have been referred to medical outpatients, four were known epileptics who presented following a seizure, and none of the others merited admission on severity criteria. Ten patients were triaged after 10.00 pm, when discharge becomes more difficult. Forty-two patients required an investigation which delayed discharge.

With the present community and investigation facilities available, there is no evidence that the majority of 24-hour admissions to acute General Medicine are inappropriate.