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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Capital Coast Health Ltd, Wellington.
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Burgess
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006757:Hospital Units / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D007388:Internal Medicine; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009520:New Zealand; D010343:Patient Admission / Q000592:standards*; D012017:Referral and Consultation; D012720:Severity of Illness Index; D013997:Time Factors; D014218:Triage; D014600:Utilization Review