Alternatives to hospital care: What are they and who should decide?

Inglis, Abby; Frankel, Stephen; Sabey, Abigail; Coast, Joanna; Frankel, S. J.

Abstract

Objective: To examine potential for alternatives to care in hospitals for acute admissions, and to compare the decisions about these alternatives made by clinicians with different backgrounds. Design: Standardised tool was used to identify patients who could potentially be treated in an alternative form of care. Information about such patients was assessed by three panels of clinicians: General practitioners without experience of general practitioner beds, general practitioners with experience of general practitioner beds, and consultants. Setting: One hospital for acute admissions in a rural area of the South and West region of England. Subjects: Of 620 patients admitted to specialties of general medicine and care of the elderly, details of 112 were assessed by panels. Main outcome measures: Proportion of hospitalised patients who could have received alternative care and identification of most appropriate alternative form of care. Results: Both general practitioner panels estimated that between 51 and 89 of the hospitalised patients could have received alternative care (equivalent to 8-14% of all admissions). Consultants estimated that between 25 and 55 patients could have had alternative care (5.5-9% of all admissions). General practitioner bed and urgent outpatient appointment were the main alternatives chosen by all three panels. Conclusion: About 10% of admissions to general hospital might be suitable for alternative forms of care. Doctors with different backgrounds made similar overall assessments of most appropriate forms of care. © 1996, BMJ Publishing Group Ltd. All rights reserved.

• Journal Article Type: Article
• Publication Date: Jan 20, 1996
• Journal: BMJ
• Print ISSN: 0959-8138
• Electronic ISSN: 1756-1833
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 312
• Issue: 7024
• Pages: 162-166
• DOI: https://doi.org/10.1136/bmj.312.7024.162
• Keywords: acute hospital, secondary care, hospital admissions
• Public URL: https://uwe-repository.worktribe.com/output/1104859
• Publisher URL: http://dx.doi.org/10.1136/bmj.312.7024.162