PRIMARY HEALTH-CARE REPLACING HOSPITAL-CARE - THE EFFECT ON QUALITY OF CARE

In order to change current practice concerning hospital stays, a proje ct was initiated in which shortening hospital stay was combined with s hifting care to primary health care, Research was aimed at assessing q uality of care of shortened hospital stays with home care by the commu nity nurse and/or the general practitioner (GP), A randomized clinical trial was conducted with three subgroups: 1. traditional hospital sta y; 2. hospital admission on the day of surgery, discharge the day afte r; two consultations at the outpatient department; one visit by the co mmunity nurse before surgery, two visits after; 3. mostly as for 2. wi th two GP visits replacing the two consultations at the outpatient dep artment, The selected surgical procedures were: laparoscopic cholecyst ectomy, varicose veins, removal of osteosynthesis material, hernia sur gery and other minor surgery (normal hospital stay 4-6 days), Every mo tivated patient meeting the inclusion criteria entered the study, Duri ng one year 120 patients were thus selected, Only minor differences we re found between the three subgroups in the resulting quality of care, It is concluded that late admission and early discharge even without after discharge care is feasible in most cases for healthy patients. C opyright (C) 1996 Elsevier Science Ltd.