Biomaterial Database

Variation in general practice medical admission rates for elderly people. 2000

P Ambery, and I P Donald

Elderly Care Unit, Gloucestershire Royal Hospital.

BACKGROUND Emergency medical admissions are rising, particularly in the elderly. Variation in admission rates between general practices has received little attention, and requires explanation. METHODS A retrospective review was carried out of emergency medical admissions to the District General Hospital (DGH) and the Community Hospitals (CHs) in West Gloucestershire in subjects over 75 years of age during 3 years. A survey of general practitioner (GP) attitudes to emergency admissions was carried out. RESULTS A five-fold spread in DGH and CH admission rates for elderly medical emergencies was found, and a three-fold spread of overall admission rates. Rates were consistent within a practice each year. The spreads of practice mortality rates and myocardial infarction admission rates were smaller. The variation between practices was not explained by the Jarman Index or by attitudes identified in GPs. Practices with high admission rates had slighter higher annual hospital mortality rates, but lower episode fatality rates. CONCLUSIONS Admission rates show considerable variation between practices, which is only partly explained by morbidity rates, and consistency over 3 years.

UI	MeSH Term	Description	Entries
D010343	Patient Admission	The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution.	Voluntary Admission,Admission, Patient,Admission, Voluntary,Admissions, Patient,Admissions, Voluntary,Patient Admissions,Voluntary Admissions
D010818	Practice Patterns, Physicians'	Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.	Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D011795	Surveys and Questionnaires	Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions.	Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D012017	Referral and Consultation	The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.	Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D004630	Emergencies	Situations or conditions requiring immediate intervention to avoid serious adverse results.	Emergency
D004739	England	A part of Great Britain within the United Kingdom.
D005194	Family Practice	A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.	Family Practices,Practice, Family,Practices, Family
D006764	Hospitals, Community	Institutions with permanent facilities and organized medical staff which provide the full range of hospital services primarily to a neighborhood area.	Community Hospital,Community Hospitals,Hospital, Community
D006769	Hospitals, General	Large hospitals with a resident medical staff which provides continuous care to maternity, surgical and medical patients.	General Hospital,General Hospitals,Hospital, General
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man