title: Global hospital bed utilization crisis. A different approach.
abstract: OBJECTIVE
  To test the effect of improved physician availability on hospital bed utilization.
  
  
  METHODS
  A prospective cohort study was conducted from 1st January 2009 to 31st March 2009 in the Division of Internal Medicine (DIM), King Abdul-Aziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. Two clinical teaching units (CTU) were compared head-to-head. Each CTU has 3 consultants. The CTU-control provides standard care, while the CTU-intervention was designed to provide better physician-consultant availability. Three outcomes were evaluated: patient outsourcing to another hospital, patient discharge during weekends, and overall admissions. Statistical analysis was carried out by electronic statistics calculator from the Center for Evidence-Based Medicine.
  
  
  RESULTS
  Three hundred and thirty-four patients were evaluated for admission at the Emergency Room by both CTU's. One hundred and eighty-three patients were seen by the CTU-control, 6 patients were outsourced, and 177 were admitted. One hundred fifty-one patients were seen by the CTU-intervention: 39 of them were outsourced, and 112 were admitted. Forty-eight weekend patient discharges occurred during this period of time: 21 by CTU-control, and 27 by CTU-intervention. Analysis for odds ratio in both the rate of outsourcing, and weekend discharges, showed statistical significance in favor of the intervention group.
  
  
  CONCLUSIONS
  The continuous availability of a physician-consultant for patient admission evaluation, outsourcing, or discharge during regular weekdays and weekends at DIM, KAMC proved to have a positive impact on bed utilization.
authors.affiliation: Department of Medicine, Division of Internal Medicine, King bdul-Aziz Medical City, Riyadh, Kingdom of Saudi Arabia. n4a1w@yahoo.com
authors.forename: Abdelkarim
authors.initials: A
authors.lastname: Waness
authors.forename: Jalal U
authors.initials: JU
authors.lastname: Akbar
authors.forename: Mubashar
authors.initials: M
authors.lastname: Kharal
authors.forename: Salih
authors.initials: S
authors.lastname: BinSalih
authors.forename: Mohammed
authors.initials: M
authors.lastname: Harakati
mesh_terms: D039602:After-Hours Care; D001509:Bed Occupancy; D003441:Crowding; D006297:Health Services Accessibility; D006784:Hospitals, Teaching; D006801:Humans; D017063:Outcome Assessment, Health Care; D020416:Outsourced Services; D010343:Patient Admission; D010351:Patient Discharge; D010360:Patient Transfer; D010820:Physicians / Q000600:supply & distribution; D011446:Prospective Studies; D012529:Saudi Arabia