Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Edgbaston, Birmingham, B15 2GW, UK. ORCiD ID = 0000-0003-0596-8515.
Departments of Acute Medicine, Manchester University NHS Foundation Trust, UK, M23 9LT and The Christie, Manchester, M20 4BX, UK. ORCID ID: 0000-0001-6114-1956.
Acute Med. 2022;21(1):27-33. doi: 10.52964/AMJA.0889.
Medical admissions to hospital represent a diverse range of patients, from those managed on ambulatory pathways through Same Day Emergency Care (SDEC) services, to those requiring prolonged inpatient admission. An understanding of current patterns of admission through acute medicine services and patient factors associated with longer hospital admission is needed to guide service planning and improvement.
Data from the Society for Acute Medicine Benchmarking Audit (SAMBA) 2021 were analysed. Patients admitted to acute medicine services during a 24-hour period on 17th June 2021 were included, with data recording patient demographics, frailty score, acuity and follow-up of outcomes after seven days.
8101 unplanned medical admissions were included, from 156 hospitals. 31.6% were discharged without overnight admission; the median hospital performance was 30.1% (IQR 19.3-39.3%). 22.1% of patients remained in hospital for more than 7 days. Those remaining in hospital for more than 48 hours and for more than seven days were more likely to be aged over 70, to be frail, or to have a NEWS2 of 3 or more on arrival to hospital.
The proportion of acute medical attendances receiving overnight admission varies between hospitals. Length of stay is impacted by patient factors and illness acuity. Strategies to reduce inpatient service pressures must ensure effective care for older patients and those with frailty.
医院的医疗入院患者包括从通过门诊途径和当天急诊服务（Same Day Emergency Care，SDEC）管理的患者，到需要长期住院的患者，具有多样性。为了指导服务规划和改进，需要了解通过急性医学服务入院的当前模式和与住院时间延长相关的患者因素。
对 2021 年急性医学基准测试协会（Society for Acute Medicine Benchmarking Audit，SAMBA）的数据进行了分析。纳入了 2021 年 6 月 17 日 24 小时内急性医学服务收治的患者，记录患者的人口统计学数据、脆弱性评分、疾病严重程度以及 7 天后的结局随访情况。
共纳入了来自 156 家医院的 8101 例非计划性内科入院患者，31.6%的患者未住院过夜；中位数医院绩效为 30.1%（IQR 19.3-39.3%）。22.1%的患者在医院停留时间超过 7 天。在医院停留超过 48 小时和超过 7 天的患者更有可能年龄超过 70 岁，身体脆弱，或入院时的 NEWS2 评分达到 3 分或更高。
不同医院接受过夜住院的急性内科就诊患者比例不同。住院时间的长短受到患者因素和疾病严重程度的影响。减少住院服务压力的策略必须确保为老年患者和身体脆弱的患者提供有效的护理。
