Differences between self-referred and physician-referred hospital admissions.
OBJECTIVE
Compare self- and physician-referred hospital admissions.


METHODS
Analysis of data prospectively collected on 3,076 consecutive acute medical admissions to a small hospital.


RESULTS
Self-referred patients were younger (50.6 vs. 63.7 years) and more likely to be smokers and drinkers. Conversely, physician-referred patients were more likely to present later, be ex-smokers, ex-drinkers and have poor prior health. More self-referred admissions were related to parasuicide and/or alcohol (27% vs. 4.5%). The physical, x-ray and laboratory findings of both types of patient were similar. Although self-referred patients had a shorter length of stay (3.8 days vs. 6.0 days) and a lower death rate (1.5% vs. 3.8%),they had higher 30-day readmission rates (14.6% vs. 8.5%).


CONCLUSIONS
Self-referred patients are less sick than those referred for hospital admission by a physician, have less psychosocial support, more alcohol-related illness and are nearly twice as likely to be readmitted within 30 days of discharge
Kellett
J
J
Department of Medcine, Nenagh Hospital, Nenagh, Co. Tipperary. jgkellett@eircom.net
McKeown
P
P
Deane
B
B
D000208:Acute Disease / Q000145:classification*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*