Coast J, Inglis A, Frankel S
Department of Social Medicine, University of Bristol.
BMJ. 1996 Jan 20;312(7024):162-6. doi: 10.1136/bmj.312.7024.162.
To examine potential for alternatives to care in hospitals for acute admissions, and to compare the decisions about these alternatives made by clinicians with different backgrounds.
Standardised tool was used to identify patients who could potentially be treated in an alternative form of care. Information about such patients was assessed by three panels of clinicians: general practitioners without experience of general practitioner beds, general practitioners with experience of general practitioner beds, and consultants.
One hospital for acute admissions in a rural area of the South and West region of England.
Of 620 patients admitted to specialties of general medicine and care of the elderly, details of 112 were assessed by panels.
Proportion of hospitalised patients who could have received alternative care and identification of most appropriate alternative form of care.
Both general practitioner panels estimated that between 51 and 89 of the hospitalised patients could have received alternative care (equivalent to 8-14% of all admissions). Consultants estimated that between 25 and 55 patients could have had alternative care (5.5-9% of all admissions). General practitioner bed and urgent outpatient appointment were the main alternatives chosen by all three panels.
About 10% of admissions to general hospital might be suitable for alternative forms of care. Doctors with different backgrounds made similar overall assessments of most appropriate forms of care.
研究急性入院患者在医院接受替代护理的可能性，并比较不同背景的临床医生对这些替代方案的决策。
使用标准化工具识别可能接受替代护理形式治疗的患者。三组临床医生对这类患者的信息进行了评估：没有全科医生床位经验的全科医生、有全科医生床位经验的全科医生以及顾问医生。
英格兰西南部农村地区的一家急性入院医院。
在620名入住普通内科和老年护理专科的患者中，112名患者的详细信息由各小组进行了评估。
可接受替代护理的住院患者比例以及确定最合适的替代护理形式。
两个全科医生小组估计，51至89名住院患者本可接受替代护理（相当于所有入院患者的8 - 14%）。顾问医生估计，25至55名患者本可接受替代护理（占所有入院患者的5.5 - 9%）。全科医生床位和紧急门诊预约是所有三个小组选择的主要替代方案。
综合医院约10%的入院患者可能适合采用替代护理形式。不同背景的医生对最合适的护理形式做出了相似的总体评估。
