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At least 19 recordsLinked to original sources
PubMedDate not supplied

[Which wards or hospital departments admit mentally ill patients? An analysis of hospital admissions recorded by the German Statutory Sickness Insurance Body in the light of the introduction of German budgeting practice].

STUDY OBJECTIVE: As from 2004, a diagnosis-related group financing system will be introduced in all somatic departments and wards in Germany. In future, only psychiatric and psychosomatic departments will continue the system of patient-related per capita budgeting. In view of this fact, it is necessary to determine which hospital wards or departments admit mentally ill patients, as the funding--and hence the therapeutic options available--will vary fundamentally between psychiatric and somatic departments. METHOD: An evaluation was made of more than 1,000,000 hospitalised patients on the books of the country's second largest medical insurance organization, the DAK, in the year 2001. Of these cases, almost 68,000 were in the diagnostic category F (psychiatric diagnoses) ICD-10. FINDINGS: Some 32.4 % of cases where the main diagnosis upon dismissal was psychiatric were admitted to somatic wards, most of them (19.3 % of the total) to internal medicine wards. A comparison between the different Federal States of Germany showed that the practice of admitting a substantial proportion of psychiatric diagnoses to somatic wards was not a merely regional problem, but widespread throughout the country. A disproportionately large number of those in somatic wards, mainly internal medicine wards, were in the diagnostic categories F13 (medication dependency), F10 (alcohol-related), F0-09 (cerebral organic disorders) and F40-48 (neurotic disorders). As a rule, the duration of hospital stay on somatic wards was less than half as long as on psychiatric wards. Two thirds of the internal medicine departments that dismissed patients with psychiatric diagnoses were in general hospitals that did not have their own psychiatric department. On the internal medicine wards the second most common diagnostic group in the age group 16-64 years, after ischaemic heart disease (I25), was alcohol-related disorders (F10). CONCLUSIONS: On the basis of these findings one could expect to find "mixed funding" of specific types of psychiatric diagnosis upon the introduction of the German budgeting practice system, although as a rule this will probably apply mainly to internal medicine departments with psychiatric budgets. As this system encourages shorter periods of hospitalization it seems likely that some of these patients will be transferred to psychiatric/psychosomatic wards after just a few days. However, it appears unlikely that there will be a corresponding increase in the number of psychiatric beds. For this reason, it is important that provision be made to accommodate psychiatric cases elsewhere, preferably in somatic, mainly internal medicine, wards. This expansion of capacity should also include the extension of activities carried out by the psychiatric/psychosomatic counselling and liaison services, as well as the introduction of short crisis intervention techniques and the so-called qualified detoxification of alcohol-abuse patients on internal medicine wards. As the present system offers no incentive to general hospitals to take such measures we can expect demand for beds in psychiatric/psychosomatic hospitals to increase. Furthermore, it is probable that there will also be an increase in the number of re-admissions of such patients, especially alcoholics, to somatic wards.

Adolescent↗
PubMed1999

Revamped preadmission process removes bottlenecks, boosts number of outpatient surgeries.

Partnering with outside organizations to reengineer a hospital function can be tricky if it's not well executed. MedCenter Hospital in Marion, OH, played its cards right and got an outside physician clinic to be a key player in helping a task force redesign the preadmission process for the hospital's outpatient surgeries. The new and improved system boosted the number of monthly outpatient surgeries, resulting in increased revenue for the hospital.

Admitting Department, Hospital↗
PubMedDate not supplied

Educational hospitalization of family practice residents: how we do it, what it costs.

Admission of first-year residents to a hospital enables them to experience the process from the patient's point of view and fosters physician empathy for the frustrations, loneliness, and uncertainty that patients go through when hospitalized. However, experiential learning programs of this type are complex and resource intensive. This article outlines the nature of resident and faculty participation in this educational exercise and documents the roles played by hospital departments (admitting, nursing, billing, medical records, employee health, and public relations) in enabling us to carry out an anonymous, and thus realistic, hospital admission experience. We also stress the pivotal role of strong administrative support for this type of program, especially when occasional glitches arise. Finally, we document the cost, which averages $1,137 per resident for their overnight stay, as reflected in actual hospital bills.

Costs and Cost Analysis↗
PubMed1999

Hepatitis C virus infection risk factors in patients admitted in hospital emergency departments in Picardy. Value of oriented screening based on recommendations of the 'Direction Générale de la Santé'.

OBJECTIVE AND DESIGN: Oriented hepatitis C virus (HCV) screening on the basis of transfusion, previous or current parenteral drug addiction, invasive procedures, and in family members of patients with hepatitis C, was recommended in France by the 'Direction Générale de la Santé' (DGS). The aim of this study was to estimate the frequency of these risk factors in patients admitted in hospital emergency departments in Picardy. METHODS: Between 1 June and 31 July 1996, physicians of the emergency units of seven hospitals in Picardy were asked to question admitted patients about risk factors mentioned in the DGS recommendations, and to suggest a screening test when at least one of these risk factors was present. RESULTS: Among 1648 patients, 68.7% had at least one of these risk factors. Screening was accepted by 723 patients, 58.7% of those with at least one risk factor, and more than 70% of those with history of transfusion and/or drug addiction. It was immediately performed in 451, and 2.4% had anti-HCV antibodies. The prevalence of anti-HCV antibodies was 1.5% in patients without history of transfusion or drug addiction and 7.9% in those with at least one of these two risk factors. CONCLUSION: Oriented screening based on transfusion or drug addiction history seems to have better efficiency than the screening policy recommended by the DGS. Poor reliability of answers about medical history was observed probably because of stress related to emergency circumstances. A screening test proposed to patients with these major risk factors by their usual physician would be probably more efficient.

Aged↗
PubMed1997

[Relevance of the 112-emergency calls among the clientele of the emergency department of the Herlev hospital admitting office].

It is a common view, shared by Emergency Department staff and ambulance crews, that a large number of patients unnecessarily use Emergency Service ambulances instead of transporting themselves to the hospital by other, more appropriate means. In this retrospective study, 528 consecutive Emergency Service calls to the Herlev Hospital Casualty/Emergency Department during a six week period were reviewed for relevance. Attention was solely aimed at the relevance of the use of Emergency Service ambulances in each case, but not on patient or health care providers' perception of urgency. All calls resulting in admission to hospital were pre-defined as being relevant. Seventeen point six percent of all calls were deemed irrelevant. Thirty-three percent of all calls not resulting in admission were deemed irrelevant. The results confirm Emergency Department health care providers' and ambulance crews' view that Emergency Service ambulances are used inappropriately by the public.

Ambulances↗