A medical admission unit reduces duration of hospital stay and number of readmissions.

Danish medical bulletin Pub Date : 2011-08-01
Jan C Vork, Mikkel Brabrand, Lars Folkestad, Kristian Korsgaard Thomsen, Torben Knudsen, Christian Christiansen
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Abstract

Introduction: Political initiatives promoting a more efficient emergency admission process have triggered a reorganisation of the Danish health system with a view to creating fewer and larger admission units counting more experienced physicians. At our hospital, a medical admission unit (MAU) was established. We present the effect of this on the length of hospital stay, mortality rates and the number of readmissions for the last year with the previous structure and the first year of the new MAU structure.

Material and methods: We retrospectively extracted data from the hospital databases on two periods: one year before and the first year after establishment of the MAU.

Results: After establishment of the MAU, the overall average length of hospital stay was reduced from 4.1 to 3.8 days (p < 0.01). No increase in mortality either in-house or within 30 days after discharge was seen. A substantial reduction (26%) in the overall number of readmissions within 30 days after discharge was observed.

Conclusion: The establishment of the MAU improved efficacy at the hospital owing to reduction in the length of hospital stay and the number of readmissions. As judged from mortality rates and indicated by readmission rates, neither the quality of treatment nor patient safety was compromised in a setup, where patients with suspected cardiac diseases are admitted along with patients suspected to suffer from other internal medical diseases. The dynamics between multidisciplinary physicians and nurses seems to improve when they are working close to each other in a setting where team spirit evolves.

Funding: not relevant.

Trial registration: not relevant.

医疗住院单位减少了住院时间和再入院人数。
导读:促进更有效的急诊入院过程的政治举措引发了丹麦卫生系统的重组,目的是创建更少和更大的入院单位,有更多经验丰富的医生。在我们医院,设立了一个住院病房。我们介绍了这对住院时间、死亡率和再入院人数的影响,在前一年的结构和新MAU结构的第一年。材料和方法:我们回顾性地从医院数据库中提取了两个时期的数据:建立MAU前一年和建立MAU后第一年。结果:MAU建立后,患者总平均住院时间由4.1天缩短至3.8天(p < 0.01)。住院期间或出院后30天内的死亡率均未见增加。观察到出院后30天内再入院总人数大幅减少(26%)。结论:MAU的建立减少了住院时间和再入院次数,提高了医院的疗效。从死亡率和再入院率来看,在怀疑患有心脏病的患者与怀疑患有其他内科疾病的患者一起入院的情况下,治疗质量和患者安全都没有受到损害。当多学科医生和护士在团队精神发展的环境中彼此密切合作时,他们之间的动态似乎得到了改善。资金:不相关。试验注册:不相关。
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Danish medical bulletin
Danish medical bulletin 医学-医学:内科
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