FACTORS ASSOCIATED WITH INAPPROPRIATE EMERGENCY HOSPITAL ADMISSION INTHE UK

This paper reports an attempt to assess the factors associated with in appropriate acute hospital admission using the technique of logistic r egression, Data were obtained from two separate studies of acute hospi tal utilization in southwest England, conducted between 1992 and 1994, The appropriateness of admission was assessed using explicit standard ized criteria in the form of the intensity-severity-discharge review s ystem with adult criteria (ISD-A), Up to 19 explanatory variables were available for the analyses, These variables were modelled for each ce ntre separately, using logistic regression to produce final sets of fa ctors independently related to the appropriateness of admission, For o ne centre, the final model contained age/specialty and use of communit y services, For the other, the final model contained two measures of h ealth status on admission-coping failure and admission with stroke, It is concluded that the complex interplay between the characteristics o f patients, referrers, alternative forms of care and the acute hospita l may result in quite different types of inappropriate admissions in d ifferent locations.