title: Appropriateness of acute admissions and last in-patient day for patients with long term neurological conditions.
abstract: BACKGROUND
  To examine the appropriateness of admissions and in-patient stay for patients with long term neurological conditions (LTNCs). To identify variables predictive of appropriateness and explore management alternatives.
  
  
  METHODS
  Adults admitted as acute patients to Derby Hospitals NHS Foundation Trust (England). Data were collected prospectively and examined by a multi-disciplinary expert panel to determine the appropriateness of admission and length of stay (LoS). Management alternatives were discussed.
  
  
  RESULTS
  A total of 119 participants were recruited. 32 admissions were inappropriate and 83 were for an inappropriate duration. Whether a participant lived in their own home was predictive of an inappropriate admission. The number of LTNCs, number of presenting complaints and whether the participant lived alone in their own home were predictive of an inappropriate LoS. For admissions judged to be inappropriate, the panel suggested management alternatives.
  
  
  CONCLUSIONS
  Patients with LTNCs are being admitted to hospital when other services, e.g. ambulatory care, are available which could meet their needs. Inefficiencies in hospital procedures, such as discharge planning and patient transfers, continue to exist. Recognition of the need to plan for discharge at admission and to ensure in-patient services are provided in a timely manner may contribute towards improved efficiency.
authors.affiliation: Rehabilitation Research and Education Group, School of Community Health Sciences, University of Nottingham, UK. mcxclh@nottingham.ac.uk
authors.forename: Christina L
authors.initials: CL
authors.lastname: Hammond
authors.forename: Margaret F
authors.initials: MF
authors.lastname: Phillips
authors.forename: Lorraine L
authors.initials: LL
authors.lastname: Pinnington
authors.forename: Benedict J
authors.initials: BJ
authors.lastname: Pearson
authors.forename: Apostolos
authors.initials: A
authors.lastname: Fakis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D004739:England; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007902:Length of Stay; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009422:Nervous System Diseases / Q000503:physiopathology / Q000628:therapy*; D010343:Patient Admission; D013222:State Medicine