title: Avoidable emergency admissions?
abstract: BACKGROUND
  Use of specialist healthcare services is increasing.
  
  
  OBJECTIVE
  To evaluate whether alternative healthcare services could reduce the need for admissions to specialist care hospitals.
  
  
  METHODS
  Prospective observational study of emergency referrals for admission to specialist care.
  
  
  METHODS
  A single out-of-hours primary care centre (OPCC) in Norway.
  
  
  METHODS
  Out-of-hours physicians registered their referrals for hospital admission and stated whether the admission could have been avoided given the availability of six other healthcare services.
  
  
  RESULTS
  Of 1083 registered encounters at the OPCC, 152 (14%) were referred for specialist care hospital admission. According to the referring physician, 32 (21%) of these referrals could have been avoided. The most eligible alternatives to such referrals were next-day appointments at a specialist outpatient clinic (11 of 32 referrals), or admission to a community hospital (21 of 32 referrals), or a nursing home (nine of 32 referrals). Respiratory (eight of 32 referrals) and gastrointestinal problems (12 of 32 referrals) were the most common among avoidable admissions.
  
  
  CONCLUSIONS
  The use of specialist care hospital admission can be reduced if appropriate alternatives are available.
authors.affiliation: Out-of-Hours Primary Care Centre, Varnesregionen, Stjørdal, Norway. borge.lillebo@varnesregionen.no
authors.forename: Borge
authors.initials: B
authors.lastname: Lillebo
authors.forename: Bodil
authors.initials: B
authors.lastname: Dyrstad
authors.forename: Anders
authors.initials: A
authors.lastname: Grimsmo
mesh_terms: D000293:Adolescent; D000328:Adult; D039602:After-Hours Care / Q000706:statistics & numerical data; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009664:Norway; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000592:standards / Q000706:statistics & numerical data*; D055815:Young Adult