title: A medical admission unit reduces duration of hospital stay and number of readmissions.
abstract: BACKGROUND
  Political initiatives promoting a more efficient emergency admission process have triggered a reorganisation of the Danish health system with a view to creating fewer and larger admission units counting more experienced physicians. At our hospital, a medical admission unit (MAU) was established. We present the effect of this on the length of hospital stay, mortality rates and the number of readmissions for the last year with the previous structure and the first year of the new MAU structure.
  
  
  METHODS
  We retrospectively extracted data from the hospital databases on two periods: one year before and the first year after establishment of the MAU.
  
  
  RESULTS
  After establishment of the MAU, the overall average length of hospital stay was reduced from 4.1 to 3.8 days (p < 0.01). No increase in mortality either in-house or within 30 days after discharge was seen. A substantial reduction (26%) in the overall number of readmissions within 30 days after discharge was observed.
  
  
  CONCLUSIONS
  The establishment of the MAU improved efficacy at the hospital owing to reduction in the length of hospital stay and the number of readmissions. As judged from mortality rates and indicated by readmission rates, neither the quality of treatment nor patient safety was compromised in a setup, where patients with suspected cardiac diseases are admitted along with patients suspected to suffer from other internal medical diseases. The dynamics between multidisciplinary physicians and nurses seems to improve when they are working close to each other in a setting where team spirit evolves.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Medical Admission Unit, Hospital of Southwest, Esbjerg, Denmark. janc@dadlnet.dk
authors.forename: Jan C
authors.initials: JC
authors.lastname: Vork
authors.forename: Mikkel
authors.initials: M
authors.lastname: Brabrand
authors.forename: Lars
authors.initials: L
authors.lastname: Folkestad
authors.forename: Kristian Korsgaard
authors.initials: KK
authors.lastname: Thomsen
authors.forename: Torben
authors.initials: T
authors.lastname: Knudsen
authors.forename: Christian
authors.initials: C
authors.lastname: Christiansen
mesh_terms: D003718:Denmark; D004632:Emergency Medical Services / Q000458:organization & administration*; D017052:Hospital Mortality; D006801:Humans; D007400:Interprofessional Relations; D007902:Length of Stay / Q000706:statistics & numerical data*; D008505:Medical Staff, Hospital / Q000458:organization & administration; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies