An Examination of the Need for Hospital Admission

Mackintosh, JeanM; McKeown, Thomas; Garratt, F.N.

doi:10.1016/s0140-6736(61)90133-7

Cited by 27 publications

(10 citation statements)

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“…The second strand that may be relevant to understanding the marital variations in hospital use concerns the social causes and consequences of occupying a particular status, and draws upon evidence of the mixture of clinical and non-clinical criteria that are taken into account in admission and discharge decisions (Forsyth and Logan, 1960;Mackintosh et al, 1961;Butler and Pearson, 1970).…”

Section: Discussionmentioning

confidence: 99%

Marital status and hospital use.

Butler

Morgan

1977

Journal of Epidemiology & Community Health

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SUMMARY Published data from the Hospital In-Patient Enquiry (1973) are used to examine the relationship between hospital use and marital state. Non-married men and women are shown to have higher discharge rates and longer mean durations of stay than married patients in the corresponding age groups, and to account, on average, for about 24 000 additional beds each day in non-psychiatric hospitals. Hospital Activity Analysis data from one region suggest that the higher rates of bed use by non-married patients as a whole are maintained for both single and widowed patients separately, and the differences are also observed in all types of nonpsychiatric hospitals. Two possible modes of explanation are discussed: that the incidence and possibly the severity of conditions that are normally treated in hospital may be differentially distributed among marital status groups; and that non-clinical factors in decisions about admission and discharge may be associated more commonly with non-married than married patients. The results carry no normative implications for the uses to which hospital resources should be put.

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Section: Discussionmentioning

confidence: 99%

Marital status and hospital use.

Butler

Morgan

1977

Journal of Epidemiology & Community Health

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“…A second, using consultant opinions, reported similar findings for existing inpatients (Forsyth & Logan 1960). A further, larger survey in Birmingham, focusing on admissions and delayed discharges, reported 4.7% admissions, and a further 13.3% of delayed discharges, unnecessary on medical grounds alone (Mackintosh & Garrat 1961).…”

Section: Implicit Criteria Instrumentsmentioning

confidence: 95%

Central dimensions of clinical practice evaluation: efficiency, appropriateness and effectiveness ‐ I

Miles

O'Neill

Polychronis

1996

Evaluation Clinical Practice

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Successful audit of clinical practice focuses upon the systematic investigation of key aspects of the everyday work of busy clinicians. We contend that the nature and quality of local clinical practice can be characterized by critical examinations of the effectiveness and appropriateness of practice and the efficiency with which effective, appropriate clinical care is delivered to patients. When such a baseline has been established, it becomes possible to compare and contrast characterized local practice with so-called 'evidence-based' practice and agree changes aimed at narrowing the discrepancy between the two. The nature of such changes can be described and their implementation into practice studied, with subsequent quantitative measurement and qualitative description of the resulting benefits to patients. A proper understanding of the concepts of efficiency, appropriateness and effectiveness in clinical care is clearly fundamental to the successful design and applications of methodologies aimed at securing measurable improvements in the quality of patient care. In this first of two articles we examine the concepts of efficiency and appropriateness in clinical practice, with particular emphasis on cost-effectiveness and utilization review. The clinical effectiveness of health care intervention is treated in detail within the second paper, to be published within Volume 2 Number 2 of the Journal of Evaluation in Clinical Practice (Miles et al. 1996f).

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“…This contrasts with the surveys of Cromhie and Cross (1959) and of Forsyth and Logan (1960), where this question was raised. The question has been discussed at length by Mackintosh, McKeown and Garratt (1961). The acute major illnesses included a number of "strokes" during the first stage where the state of con sciousness was altered or a complication had arisen.…”

Section: Number Of Admissionsmentioning

confidence: 99%