title: Changes in the pattern of work in a rural community hospital 1987-1997.
abstract: OBJECTIVE
  To examine time trends in clinical activity at a rural community hospital, and to assess associated changes in the complexity of the care received by inpatients.
  
  
  METHODS
  Descriptive study utilising routine Scottish Morbidity Records data (SMRO1) and locally collected data, along with a retrospective review of admission case notes to quantify clinical inputs to patient care.
  
  
  METHODS
  Portree community hospital on the island of Skye.
  
  
  METHODS
  Patients admitted to Portree community hospital in 1987, 1992 and 1997.
  
  
  RESULTS
  We found an 80 per cent rise in total annual admissions between 1987 and 1997 and a 34 per cent rise in annual casualty attendance between 1992 and 1997. There was a significant reduction in the median duration of in-patient stay, from 8.5 days in 1987 to 6.0 days in 1997. The case-mix of admissions altered significantly between 1992 and 1997. We also demonstrated significant changes in the proportion of patients receiving blood transfusions or intravenous (i.v.) fluids during this time period.
  
  
  CONCLUSIONS
  There have been significant changes in the pattern of use of this community hospital over the past 12 years. The rise in total admissions and casualty attendances, combined with the fall in duration of stay reveal an overall increase in activity at the hospital. This has been associated with changes in the clinical spectrum of admissions. Taken together with the results of the workload analysis, it seems likely that the complexity of the clinical input required at the hospital has increased, and that the role of this community hospital is increasingly the provision of intermediate care to acute cases.
authors.affiliation: Portree Medical Centre, Portree, Isle of Skye.
authors.forename: K
authors.initials: K
authors.lastname: Licence
authors.forename: C
authors.initials: C
authors.lastname: Crichton
authors.forename: C
authors.initials: C
authors.lastname: Stark
mesh_terms: D000368:Aged; D006302:Health Services Research; D006764:Hospitals, Community / Q000458:organization & administration / Q000706:statistics & numerical data* / Q000639:trends; D006780:Hospitals, Rural / Q000458:organization & administration / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000639:trends; D010343:Patient Admission / Q000639:trends; D012189:Retrospective Studies; D012606:Scotland; D014600:Utilization Review; D016526:Workload / Q000706:statistics & numerical data