[Are there alternatives to emergency admissions?].
BACKGROUND
Emergency admissions account for an increasing number of admissions to hospitals, especially to medical departments. Several hospitals in Norway are planning alternatives to emergency admissions, e.g. emergency outpatient departments and observation units.


METHODS
We registered emergency admissions to internal medicine and surgical, orthopaedic and gynaecological departments to St. Olavs University Hospital during one week in June 2003. Using questionnaires we received the admitting and the treating doctors' evaluation of the reason for admissions and also of the possibilities for alternatives as emergency care, nursing homes, observations units or treatment by general practitioners.


RESULTS
202 out of 262 admissions were included the study. Recently oncoming illness was the most important reason. For the whole group, only 10% of the admissions were caused by social issues, but social issues were often the main cause for admissions for older patients. Only 12% of the patients were admitted by their own general practitioner. An observation unit was the mostly recommended alternative to admission, but there were disagreements between primary care and hospital doctors as to which patients would be suitable. The study suggests that it is difficult to identify patients at the time of admission who could be treated without regular admission.
Eikeland
Gunvor
G
Kvinneklinikken, St. Olavs Hospital, 7006 Trondheim. gunvor.eikeland@stolav.no
Garåsen
Helge
H
Jacobsen
Geir
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004638:Emergency Treatment; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009664:Norway; D010343:Patient Admission / Q000706:statistics & numerical data / Q000639:trends; D010360:Patient Transfer; D010818:Practice Patterns, Physicians'; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires