Document Detail

Unexpected, periodic and permanent increase in medical inpatient care: man-made or new disease?
MedLine Citation:
PMID:  20138437     Owner:  NLM     Status:  MEDLINE    
For many years medical admissions to acute hospitals have been increasing at a rate far higher than expected from demographic change. Factors such as emergency re-admission, GP thresholds, breakdown of the family unit and deficiencies in community and social care have been suggested to explain this widening gap. Solutions to the problem have revolved around demand management strategies. While such strategies do result in a relative reduction in demand they are unable to prevent the underlying long-term behaviour. Analysis of daily admissions in Scotland, England and at individual hospitals over the past 25 years shows that the admissions tend to increase in a step-like manner at an interval of three to six years. This causes a typical 10% step-increase in physician work-load and inpatient medical costs and across England adds over 1,200,000 occupied bed days of additional bed demand into the health service within the space of around three months. There are knock-on effects to demand for ambulance services, accident and emergency attendance and GP referral. The step-increase is characterised by a cluster of diagnoses, increases with age and effects women more than men. Such behaviour has similarities to an infectious outbreak and the evidence for this and alternative hypotheses are discussed.
Rodney P Jones
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Publication Detail:
Type:  Journal Article     Date:  2010-02-06
Journal Detail:
Title:  Medical hypotheses     Volume:  74     ISSN:  1532-2777     ISO Abbreviation:  Med. Hypotheses     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-04-14     Completed Date:  2010-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7505668     Medline TA:  Med Hypotheses     Country:  United States    
Other Details:
Languages:  eng     Pagination:  978-83     Citation Subset:  IM    
Healthcare Analysis and Forecasting, Honister Walk, Camberley, Surrey GU15 1RQ, UK.
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MeSH Terms
Disease Outbreaks / statistics & numerical data
Great Britain / epidemiology
Health Policy
Hospitalization / statistics & numerical data,  trends*
Inpatients / statistics & numerical data
Models, Theoretical
Patient Admission / statistics & numerical data,  trends

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