title: Acute admissions to a community hospital - health consequences: a randomized controlled trial in Hallingdal, Norway.
abstract: BACKGROUND
  Health care professionals in several countries are searching for alternatives to acute hospitalization. In Hallingdal, Norway, selected acute patients are admitted to a community hospital. The aim of this study was to analyse whether acute admission to a community hospital as an alternative to a general hospital had any positive or negative health consequences for the patients.
  
  
  METHODS
  Patients intended for acute admission to the local community hospital were asked to join a randomized controlled trial. One group of the enrolled patients was admitted as planned (group 1, n = 33), while another group was admitted to the general hospital (group 2, n = 27). Health outcomes were measured by the Nottingham Extended Activity of Daily Living Questionnaire and by collection of data concerning specialist and community health care services in a follow-up year.
  
  
  RESULTS
  After one year, no statistical significant differences in the level of daily function was found between group 1 (admissions to the community hospital) and group 2 (admissions to the general hospital). Group 1 had recorded fewer in-patient days at hospitals and nursing homes, as well as lower use of home nursing, than group 2. For outpatient referrals, the trend was the opposite. However, the differences between the two groups were not at a 5% level of statistical significance.
  
  
  CONCLUSIONS
  No statistical significant differences at a 5% level were found related to health consequences between the two randomized groups. The study however, indicates a consistent trend of health benefits rather than risk from acute admissions to a community hospital, as compared to the general hospital. Emergency admission and treatment at a lower-level facility than the hospital thus appears to be a feasible solution for a selected group of patients.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01069107 . Registered 2 April 2010.
authors.affiliation: Department of Hallingdal sjukestugu, Medical Clinic of Ringerike General Hospital, Vestre Viken Hospital Trust, Ål, 3570, Norway. oystein.lappegard@vestreviken.no.
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Lappegard
authors.affiliation: Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway. per.hjortdahl@medisin.uio.no.
authors.forename: Per
authors.initials: P
authors.lastname: Hjortdahl
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006701:Home Nursing / Q000706:statistics & numerical data*; D006760:Hospitalization; D006764:Hospitals, Community; D006769:Hospitals, General; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009664:Norway; D009735:Nursing Homes / Q000706:statistics & numerical data*; D063868:Patient Outcome Assessment; D010359:Patient Readmission / Q000706:statistics & numerical data